Psychological influences on surgical recovery: Perspectives from psychoneuroimmunology.

Kiecolt‐Glaser, Janice K.; Page, Gayle G.; Marucha, Phillip T.; MacCallum, Robert C.; Glaser, Ronald

doi:10.1037/0003-066x.53.11.1209

Cited by 486 publications

(291 citation statements)

References 91 publications

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“…In agreement with these laboratory findings, several studies have shown that greater fear or distress prior to surgery is associated with poorer outcomes including longer hospital stays, more postoperative complications, and higher rates of rehospitalization 34 .…”

Section: Stress and Wound Healingsupporting

confidence: 58%

Omega-3 Fatty Acids and Stress-Induced Immune Dysregulation: Implications for Wound Healing

Kiecolt‐Glaser¹,

Glaser²,

Christian³

2016

Military Medicine

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Stress-related immune alterations can be consequential for health; they can enhance susceptibility to infectious agents and influence the severity of infectious disease, diminish the strength of immune responses to vaccines, reactivate latent viruses, and slow wound healing. Furthermore, stressful events and negative emotions promote systemic proinflammatory cytokine production while reducing beneficial local production of proinflammatory cytokines at the wound site that are important for wound healing. Dietary omega-3 and omega-6 polyunsaturated fatty acids (PUFA) also influence systemic inflammation; high proportions of omega-6 to omega-3 boost inflammation, while omega-3 has anti-inflammatory properties. Additionally, the limited evidence thus far suggests that omega-3 PUFA may enhance local inflammatory responses at wound sites. Moreover, an individual's dietary proportion of omega-3 to omega-6 may influence the magnitude of inflammatory responses to stressful events. Thus, wound healing and surgery provide exemplars of how stress and depression can interact with the diet to influence important clinical outcomes.

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Section: Stress and Wound Healingsupporting

confidence: 58%

Omega-3 Fatty Acids and Stress-Induced Immune Dysregulation: Implications for Wound Healing

Kiecolt‐Glaser¹,

Glaser²,

Christian³

2016

Military Medicine

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“…The inclusion of comparable role-play strategies may limit the adverse effects of pain on endocrine and immune function on skin wound healing (Kiecolt- Glaser et al, 1998). Also caregivers may benefit from training protocols using role-play strategies targeting self-enhancement and positive emotions related to the social meaningfulness of the work they do.…”

Section: Discussionmentioning

confidence: 99%

“…Also caregivers may benefit from training protocols using role-play strategies targeting self-enhancement and positive emotions related to the social meaningfulness of the work they do. This may reduce their short and long term risk of health deterioration (Kiecolt-Glaser et al, 1998;Glaser and Kiecolt-Glaser, 2005;Tosevski and Milovancevic, 2006).…”

Section: Discussionmentioning

confidence: 99%

Changes in self-perceived role identity modulate pain perception

Kut

Schaffner

Wittwer

et al. 2007

Pain

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Pain is an experience including physiological and psychological factors. We assume that emotions may be elicited and increased through self-perceived role identity and that change of role identity alters quality and intensity of pain perception. We used role-play strategies to assess whether pain can be better tolerated whenever, in an unavoidable and unpleasant context, role identity confers pain a meaningful and thus suitable character. We induced antithetic roles in 21 actors who received heat stimuli on their arms before and after role-play conditions. Pain tolerance, skin conductance and voice signals were measured. Pain tolerance increased for heroes/heroines and decreased for faint-hearts. Men showed higher pain tolerance. Heroes/heroines evaluated heat stimuli as more intense. Faint-hearts found pain stimuli more affectively loaded at lower temperatures. Women showed higher pain ratings. Hence, self-perception influences pain perception. Role-play strategies may be of value for new pain management strategies. AbstractPain is an experience including physiological and psychological factors. We assume that emotions may be elicited and increased through self-perceived role identity and that change of role identity alters quality and intensity of pain perception. We used role-play strategies to assess whether pain can be better tolerated whenever, in an unavoidable and unpleasant context, role identity confers pain a meaningful and thus suitable character. We induced antithetic roles in 21 actors who received heat stimuli on their arms before and after role-play conditions. Pain tolerance, skin conductance and voice signals were measured. Pain tolerance increased for heroes/heroines and decreased for faint-hearts. Men showed higher pain tolerance. Heroes/heroines evaluated heat stimuli as more intense. Faint-hearts found pain stimuli more affectively loaded at lower temperatures. Women showed higher pain ratings. Hence, self-perception influences pain perception. Role-play strategies may be of value for new pain management strategies. Ó

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“…Other research has indicated that the presence of elevated psychological symptoms may complicate treatment and may alter outcome [24,25,27,32,42,56]. That is not to say that those with a mental health diagnosis should not be considered for elective limb lengthening and reconstruction surgery.…”

Section: Background and Rationalementioning

confidence: 99%

“…Rather, all patients Table 8. Recommendations for preoperative evaluation [5,11,17,24,25,27,37,42,46,48,49] should be screened for the presence of psychiatric symptoms and appropriate management of these symptoms should be required before planning surgical intervention of this magnitude (Table 8). As the lead team member, the surgeon should be aware of the patient's preexisting mental health condition and the potential impact during treatment.…”

Section: Background and Rationalementioning

confidence: 99%

Clinical Implications of Psychosocial Factors on Pediatric External Fixation Treatment and Recommendations

Richard

Nguyen

Birch

et al. 2015

Clin Orthop Relat Res

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Background Pediatric limb reconstruction using circular external fixation is a prolonged treatment that interrupts patients' daily function. Patient personality characteristics and expectations may interfere with planned treatment, making complicated medical procedures more challenging. The aims of this study are to identify factors impacting treatment outcome and recommendations for preoperative evaluation and planning. Questions/purposes (1) Are there group differences between patients with and without a preexisting mental health condition(s) in terms of unplanned reoperations? (2) Does the number of surgical procedures before current external fixator placement correlate with the number of unplanned readmissions, unplanned reoperations, and days spent in circular external fixation? (3) Are there group differences between single-compared with two-parent households in terms of inpatient narcotic doses, length of inpatient stay, number of unplanned readmissions, length of readmission(s), and/or unplanned outpatient clinic visits? (4) Does patient age at the time of surgery have an impact on treatment duration, postoperative complications, and treatment outcome? Methods This is a retrospective chart review of pediatric patients who underwent limb reconstruction between 2008 and 2012. Patients with limb length discrepancy [ 4 cm or severe angular deformity and who agreed to intervention were treated with circular external fixation. Sixty-seven patients were included; 16 patients were excluded. Statistical analyses included Pearson r correlation and t-test. Results Patients who reported preexisting mental health diagnosis (13%) had more unplanned reoperations than patients who did not (no mental health diagnosis; 87%) (mental health diagnosis 3.4 ± 10.3 versus no mental health diagnosis 0.2 ± 0.5 reoperation[s], p = 0.022). Number of previous surgical procedures correlated with number of unplanned reoperations (r = 0.448, p \ 0.001), number of unplanned readmissions (r = 0.375, p \ 0.001), and number of days in an apparatus (r = 0.275, p = 0.018). Compared with patients from two-parent households, patients from single-parent households received a greater number of inpatient narcotic doses (singleparent 129 ± 118 versus two-parent 73 ± 109 doses, p = 0.039), longer length of inpatient stay (single-parent 73 ± 63 versus two-parent 40 ± 65 days, p = 0.036), more unplanned readmissions (single-parent 0.4 ± 0.1 versus two-parent 0.2 ± 0.2 readmission, p = 0.024), longer hospitalization when readmitted (single-parent 5 ± 11 versus two-parent 1 ± 3 day(s), p = 0.025), and fewer unplanned outpatient visits (single-parent 0.2 ± 0.8 versus two-parent 0.9 ± 1.1 visit, p = 0.005). Apparatus applications with successful outcome had higher average age than those with poor outcome (successful outcome 16 ± 3 versus poor outcome 13 ± 4 years old, p = 0.011). Age at time of apparatus application correlated with One or more of the authors (JGB, MKS, AMC), or a member of his or her immediate family, has or may receive payments ...

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Psychological influences on surgical recovery: Perspectives from psychoneuroimmunology.

Cited by 486 publications

References 91 publications

Omega-3 Fatty Acids and Stress-Induced Immune Dysregulation: Implications for Wound Healing

Omega-3 Fatty Acids and Stress-Induced Immune Dysregulation: Implications for Wound Healing

Changes in self-perceived role identity modulate pain perception

Clinical Implications of Psychosocial Factors on Pediatric External Fixation Treatment and Recommendations

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