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BACKGROUND: This paper reviews the scope of research on kinesiophobia in patients after cardiac surgery. Further, it reviews the current situation, evaluation tools, risk factors, adverse effects, and intervention methods of kinesiophobia to provide a reference for promoting early rehabilitation of patients after cardiac surgery. METHODS: Guided by the scoping methodology, the Web of Science, PubMed, CINAHL, Cochrane Library, China Biomedical Literature Database, VIP Database, Wanfang Database, CNKI, and other databases were searched from database inception until July 31, 2024. The studies obtained were screened, summarised and systematically analysed by two researchers. RESULTS: Eighteen studies (16 cross-sectional studies, one qualitative study, and one randomised controlled trial) were included. The incidence of kinesiophobia in patients after cardiac surgery was 39.20-82.57%, and the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart) was used to evaluate this incidence. The influencing factors of kinesiophobia in patients after cardiac surgery included demographic characteristics, pain severity, frailty, exercise self-efficacy, disease-related factors, and psychosocial factors. Kinesiophobia led to adverse health outcomes such as reduced recovery, prolonged hospital stays, and decreased quality of life in patients after cardiac surgery, and there were few studies on intervention methods for postoperative kinesiophobia. CONCLUSION: The kinesiophobia assessment tools suitable for patients after cardiac surgery should be improved, and intervention methods to promote the early recovery of patients after major clinical surgery and those with difficult and critical diseases should be actively researched.
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Procedimientos Quirúrgicos Cardíacos , Trastornos Fóbicos , Humanos , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Procedimientos Quirúrgicos Cardíacos/psicología , Factores de Riesgo , Trastornos Fóbicos/psicología , Trastornos Fóbicos/diagnóstico , Trastornos Fóbicos/epidemiología , Trastornos Fóbicos/etiología , Masculino , Femenino , Calidad de Vida , Persona de Mediana Edad , Anciano , Resultado del Tratamiento , Incidencia , Miedo , Dolor Postoperatorio/diagnóstico , Dolor Postoperatorio/psicología , Dolor Postoperatorio/etiología , Adulto , Medición de Riesgo , Recuperación de la Función , KinesiofobiaRESUMEN
BACKGROUND: Anxiety during oral surgery can impact patient homeostasis, increase the difficulty of the procedure and create additional stress for the surgeon. Furthermore, it has been associated with more intense and prolonged pain during and after dental treatment. OBJECTIVES: The aim of the study is to evaluate the relationship between anxiety, patient characteristics and pain outcomes in oral surgery, as well as to verify the impact of anxiety on patient's perception of pain during and after oral surgery. MATERIAL AND METHODS: This is a prospective observational study. Several variables were evaluated during the course of the oral surgery. Anxiety levels were assessed using the State-Trait Anxiety Inventory (STAI), Corah's Dental Anxiety Scale (DAS), the Interval Scale of Anxiety Response (ISAR), and Patient SelfRated Anxiety (PAnx) during the procedure. RESULTS: General anxiety measures (STAI) were not associated with specific dental anxiety or external observations of anxiety. Anxiety levels varied according to gender and body mass index (BMI), and were correlated with increased heart rate (HR) (with variability among assessment tools). Odontectomy, ostectomy and an increased volume of anesthesia were associated with higher anxiety levels (with variability among the assessment tools). There was a correlation between pain and anxiety, with anxiety contributing to approx. 12% of the variability in postoperative pain. CONCLUSIONS: Dental anxiety is a complex, multidimensional mental phenomenon characterized by high variability due to the influence of several dynamic factors.
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Anestesia Local , Ansiedad al Tratamiento Odontológico , Dimensión del Dolor , Dolor Postoperatorio , Humanos , Femenino , Masculino , Estudios Prospectivos , Dolor Postoperatorio/psicología , Persona de Mediana Edad , Adulto , Procedimientos Quirúrgicos Orales/efectos adversos , Procedimientos Quirúrgicos Orales/psicología , Anciano , AnsiedadRESUMEN
OBJECTIVES: After cardiac surgery, there may be barriers to being physically active. Patients are encouraged to gradually increase physical activity, but limited knowledge exists regarding postoperative physical activity levels. This study aimed to assess patient-reported physical activity six months after cardiac surgery, determine adherence to WHO's physical activity recommendations, and explore potential relationships between pain, dyspnea, fear of movement, and activity levels. METHODS: The study design was a cross-sectional study at Örebro University Hospital, Sweden. Preoperative and surgical data were retrieved from medical records and questionnaires concerning physical activity (Frändin-Grimby Activity Scale, the Physical activity Likert-scale Haskell, Patient-Specific Functional Scale, and Exercise Self-efficacy Scale) were completed six months after surgery. Data were collected on pain, dyspnea, general health status and kinesiophobia i.e. fear of movement, using the Tampa Scale of Kinesiophobia Heart. RESULTS: In total, 71 patients (68 ± 11 years, males 82%) participated in this study. Most patients (76%) reported a light to moderate activity level (Frändin-Grimby levels 3-4) six months after cardiac surgery. In total, 42% of the patients adhered to the WHO's physical activity recommendations (150 min/week). Pain and dyspnea were low. Patients with lower activity levels exhibited significantly higher levels of fear of movement (p =.025). CONCLUSIONS: The majority of patients reported engaging in light to moderate activity levels six months after cardiac surgery. Despite this, less than half of the patients met the WHO's physical activity recommendations. Potential barriers to physical activity such as pain, dyspnea and fear of movement were reported to be low.
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Procedimientos Quirúrgicos Cardíacos , Disnea , Ejercicio Físico , Miedo , Dolor Postoperatorio , Humanos , Masculino , Estudios Transversales , Femenino , Anciano , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Persona de Mediana Edad , Suecia , Dolor Postoperatorio/psicología , Dolor Postoperatorio/diagnóstico , Dolor Postoperatorio/etiología , Factores de Tiempo , Disnea/fisiopatología , Disnea/psicología , Disnea/diagnóstico , Anciano de 80 o más Años , Resultado del Tratamiento , Medición de Resultados Informados por el Paciente , Cooperación del Paciente , Trastornos Fóbicos/psicología , Trastornos Fóbicos/diagnóstico , Trastornos Fóbicos/fisiopatología , Conocimientos, Actitudes y Práctica en Salud , Hospitales Universitarios , KinesiofobiaRESUMEN
OBJECTIVE: Thoracic surgery is associated with one of the highest rates of chronic postsurgical pain (CPSP) among all surgical subtypes. Chronic postsurgical pain carries significant medical, psychological, and economic consequences, and further interventions are needed to prevent its development. This study aimed to determine the prevalence, characteristics, and risk factors associated with CPSP after thoracic surgery. DESIGN: A prospective cohort study. SETTING: Single-center tertiary care hospital. PARTICIPANTS: This study included 285 adult patients who underwent thoracic surgery at Toronto General Hospital in Toronto, Canada, between 2012 and 2020. MEASUREMENTS AND MAIN RESULTS: Demographic, psychological, and clinical data were collected perioperatively, and follow-up evaluations were administered at 3, 6, and 12 months after surgery to assess CPSP. Chronic postsurgical pain was reported in 32.4%, 25.4%, and 18.2% of patients at 3, 6, and 12 months postoperatively, respectively. Average CPSP pain intensity was rated to be 3.37 (SD 1.82) at 3 months. Features of neuropathic pain were present in 48.7% of patients with CPSP at 3 months and 71% at 1 year. Multivariate logistic regression models indicated that independent predictors for CPSP at 3 months were scores on the Hospital Anxiety and Depression Scale (adjusted odds ratio [aOR] of 1.07, 95% CI of 1.02 to 1.14, p = 0.012) and acute postoperative pain (aOR of 2.75, 95% CI of 1.19 to 6.36, p = 0.018). INTERVENTIONS: None. CONCLUSIONS: Approximately 1 in 3 patients will continue to have pain at 3 months after surgery, with a large proportion reporting neuropathic features. Risk factors for pain at 3 months may include preoperative anxiety and depression and acute postoperative pain.
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Dolor Crónico , Dolor Postoperatorio , Procedimientos Quirúrgicos Torácicos , Humanos , Masculino , Femenino , Estudios Prospectivos , Dolor Postoperatorio/epidemiología , Dolor Postoperatorio/psicología , Dolor Postoperatorio/etiología , Dolor Postoperatorio/diagnóstico , Factores de Riesgo , Dolor Crónico/epidemiología , Dolor Crónico/etiología , Dolor Crónico/psicología , Persona de Mediana Edad , Prevalencia , Procedimientos Quirúrgicos Torácicos/efectos adversos , Anciano , Estudios de Cohortes , Adulto , Estudios de SeguimientoRESUMEN
OBJECTIVES: This study investigated patient reported outcomes, and associations with improvement in quality of life 12-months after total hip arthroplasty (THA). MATERIALS AND METHODS: PARTICIPANTS: Adults (n = 433) undergoing THA for osteoarthritis between January 2017 and October 2020 in a large publicly funded tertiary hospital in New Zealand. Participants completed patient reported outcome measures of pain, function and quality of life (QOL) preoperatively, 6- and 12-months following THA. RESULTS: Clinically significant changes in domains of pain and function were associated with improved QOL, even when pre-operation scores were controlled for. The largest gains in all three domains occurred in the pre-to 6-month post-operation period. Baseline demographic variables such as gender and comorbidities were not associated with change in QOL pre-to post-operation. However, although modest, age at surgery was negatively correlated with change in QOL. CONCLUSIONS: THA contributes to substantial improvements in QOL, pain and function outcomes, and although possibly tempered by age, these relationships are likely to be inter-related and mutually reinforcing. Future QOL outcomes research should also consider the impacts on QOL improvement of other aspects of functioning such as psychological and social wellbeing.
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Artroplastia de Reemplazo de Cadera , Dolor Postoperatorio , Calidad de Vida , Humanos , Artroplastia de Reemplazo de Cadera/psicología , Calidad de Vida/psicología , Femenino , Masculino , Persona de Mediana Edad , Anciano , Nueva Zelanda , Dolor Postoperatorio/psicología , Osteoartritis de la Cadera/cirugía , Osteoartritis de la Cadera/psicología , Medición de Resultados Informados por el Paciente , Dimensión del Dolor , Recuperación de la Función , Adulto , Anciano de 80 o más AñosRESUMEN
Although the ankle is often involved in low energy trauma, high-energy trauma may occur, being this considered more serious and more common of affecting young and active men. The purpose of the present study was to evaluate and compare the functionality, pain and quality of life of active and inactive adult individuals whose ankle fracture was surgically treated. Seventy-six patients split into two groups (active, n = 58 X inactive, n = 18), of the men (active, n = 38; inactive, n = 9) and women (active, n = 20; inactive, n = 9) gender participated in this prospective study. The IPAQ, MMSE, SF-36, VAS, sociodemographic and clinical questionnaires were applied in person right after surgery. The SF-36 and VAS questionnaires were reapplied 3 months in average after the surgery. Active and inactive patients of both genders show significant differences (p ≤ 0.05) in the functional capacity and physical aspect domains; and the bodily pain domain revealed significant difference in active and inactive men (p ≤ 0.05) between the periods post-surgical and 3 months after surgery (on average). Moderate and significant correlations were found (p ≤ 0.05) between functional capacity, physical aspect and bodily pain domains of the SF-36 and the VAS pain scores for active and inactive patients of both genders in the final follow-up period. Other significant correlations (p < 0.05) for inactive men (physical aspect and bodily pain) and inactive women (functional capacity and bodily pain) are observed (after 3 months of surgery). Three months after surgery (on average), active and inactive men had functional limitations and pain symptoms. These factors seem to have negatively influenced the patient's social involvement, worsening their quality of life. Most active and inactive patients had a positive self-perception of their general health status, emotional aspects and mental health domains. Regarding active women, we observed lower energy and vitality after the same postoperative period.
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Fracturas de Tobillo , Calidad de Vida , Humanos , Masculino , Femenino , Fracturas de Tobillo/cirugía , Adulto , Estudios Prospectivos , Persona de Mediana Edad , Dimensión del Dolor , Encuestas y Cuestionarios , Dolor Postoperatorio/psicología , Recuperación de la Función , Fijación Interna de Fracturas , Anciano , Adulto JovenRESUMEN
OBJECTIVES: This study aimed to apply the International Association for the Study of Pain (IASP) grading system for identifying nociplastic pain in knee osteoarthritis (KOA) awaiting total knee arthroplasty (TKA) and propose criteria to fine-tune decision-making. In addition, the study aimed to characterize a "probable" versus "no or possible" nociplastic pain mechanism using biopsychosocial variables and compare both groups in their 1-year post-TKA response. METHODS: A secondary analysis of baseline data of a longitudinal prospective study involving 197 patients with KOA awaiting total TKA in Belgium and the Netherlands was performed. Two approaches, one considering 4 and the other 3 pain locations (step 2 of the grading system), were presented. Linear mixed model analyses were performed to compare the probable and no or possible nociplastic pain mechanism groups for several preoperative biopsychosocial-related variables and 1-year postoperative pain. Also, a sensitivity analysis, comparing 3 pain mechanism groups, was performed. RESULTS: Thirty (15.22%-approach 4 pain locations) and 46 (23.35%-approach 3 pain locations) participants were categorized under probable nociplastic pain. Irrespective of the pain location approach or sensitivity analysis, the probable nociplastic pain group included more woman, was younger, exhibited worse results on various preoperative pain-related and psychological variables, and had more pain 1-year post-TKA compared with the other group. DISCUSSION: This study proposed additional criteria to fine-tune the grading system for nociplastic pain (except for discrete/regional/multifocal/widespread pain) and characterized a subgroup of patients with KOA with probable nociplastic pain. Future research is warranted for further validation.
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Artroplastia de Reemplazo de Rodilla , Osteoartritis de la Rodilla , Dimensión del Dolor , Humanos , Femenino , Osteoartritis de la Rodilla/cirugía , Osteoartritis de la Rodilla/complicaciones , Osteoartritis de la Rodilla/fisiopatología , Masculino , Estudios Prospectivos , Dimensión del Dolor/métodos , Anciano , Persona de Mediana Edad , Estudios Longitudinales , Dolor Postoperatorio/diagnóstico , Dolor Postoperatorio/fisiopatología , Dolor Postoperatorio/psicología , Índice de Severidad de la Enfermedad , Bélgica , Países Bajos , Dolor/diagnóstico , Dolor/fisiopatología , Dolor/etiologíaRESUMEN
OBJECTIVES: To determine the incidence and trajectory of distress, pain, and nausea and vomiting at postoperative day (POD) 1 and at POD 14 following breast-conserving surgery. SAMPLE & SETTING: 75 women aged 18 years or older receiving breast-conserving surgery with sentinel lymph node biopsy for treatment of early-stage primary breast cancer at an ambulatory surgery center. METHODS & VARIABLES: This prospective, repeated-measures study assessed distress, pain, and nausea and vomiting using the National Comprehensive Cancer Network Distress Thermometer and Problem List on POD 1 and POD 14. RESULTS: Pain and distress scores were highest on POD 1. The number of women who reported depression increased from POD 1 to POD 14. Thematic analysis revealed that family concerns, fears and worries, and postoperative issues contributed to pain and distress. IMPLICATIONS FOR NURSING: Women experience pain and distress during recovery at home after breast-conserving surgery. Nurses can use these results to apply evidence-based practice to reduce this symptom burden. Future nursing research should focus on targeted interventions outside of the hospital setting.
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Neoplasias de la Mama , Mastectomía Segmentaria , Dolor Postoperatorio , Náusea y Vómito Posoperatorios , Humanos , Femenino , Persona de Mediana Edad , Mastectomía Segmentaria/efectos adversos , Mastectomía Segmentaria/psicología , Neoplasias de la Mama/cirugía , Neoplasias de la Mama/psicología , Anciano , Estudios Prospectivos , Dolor Postoperatorio/psicología , Dolor Postoperatorio/etiología , Adulto , Náusea y Vómito Posoperatorios/psicología , Anciano de 80 o más Años , Estrés Psicológico/psicología , Estrés Psicológico/etiología , Náusea/etiología , Náusea/psicologíaRESUMEN
PURPOSE: To investigate parental perceptions of comprehensive dental care under general anesthesia for their children. MATERIALS AND METHODS: The study included parents of children who underwent comprehensive dental care under general anesthesia. Only parents who could communicate in English were included. They were invited to participate in a telephone interview within four weeks of their children's dental treatment under general anesthesia. The interviews were designed to gather information on three main domains: problems experienced before the operation, children's well-being after the operation, and satisfaction. RESULTS: A total of 45 parents participated in the study; 91.1% identified as women and 8.8% as men. Most parents resided in areas categorised as either more deprived (51%) or most deprived (24.4%), based on deprivation indices. Prior to surgery, 66.7% of children suffered from dental pain, 44.4% were affected by dental abscesses or facial swelling, 42.2% experienced difficulties with eating and drinking, while 37.8% experienced sleeping difficulties. Painkillers were used for a short duration to manage post-operative pain (48.9%). Four weeks after the operation, many parents reported improvements in their children's mouth comfort. They observed positive changes in their children's ability to eat (40%), sleep habits (33.3%), and overall health and well-being (82.2%). Overall, most parents expressed high levels of satisfaction with the care their children received (95.5%). CONCLUSION: Parents observed improvements in their children's oral health and reported high level of satisfaction with the procedures.
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Anestesia Dental , Anestesia General , Atención Dental para Niños , Padres , Humanos , Femenino , Masculino , Padres/psicología , Niño , Preescolar , Actitud Frente a la Salud , Adulto , Dolor Postoperatorio/psicología , Adolescente , Satisfacción del PacienteRESUMEN
Pain catastrophizing is an exaggerated focus on pain sensations. It may be an independent factor influencing pain and functional outcomes of knee arthroplasty. We aimed to evaluate the association between pre-operative pain catastrophizing with pain and function outcomes up to one year after knee arthroplasty. We used data from a cohort study of patients undergoing primary knee arthroplasty (either total or unicompartmental arthroplasty) for knee osteoarthritis. Pain catastrophizing was assessed pre-operatively using the Pain Catastrophizing scale (PCS). Other baseline variables included demographics, body mass index, radiographic severity, anxiety, depression, and knee pain and function assessed using the Western Ontario and McMaster University Index (WOMAC). Patients completed the WOMAC at 6- and 12-months after arthroplasty. WOMAC pain and function scores were converted to interval scale and the association of PCS and changes of WOMAC pain and function were evaluated in generalized linear regression models with adjustment with confounding variables. Of the 1136 patients who underwent arthroplasty (70% female, 84% Chinese, 92% total knee arthroplasty), 1102 and 1089 provided data at 6- and 12-months post-operatively. Mean (± SD) age of patients was 65.9 (± 7.0) years. PCS was associated with a change in WOMAC pain at both 6-months and 12-months (ß = - 0.04, 95% confidence interval: - 0.06, - 0.02; P < 0.001) post-operatively after adjustment in multivariable models; as well as change in WOMAC function at 6-months and 12-months. In this large cohort study, pre-operative pain catastrophizing was associated with lower improvements in pain and function at 6-months and 12-months after arthroplasty.
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Artroplastia de Reemplazo de Rodilla , Catastrofización , Osteoartritis de la Rodilla , Humanos , Femenino , Masculino , Osteoartritis de la Rodilla/cirugía , Osteoartritis de la Rodilla/psicología , Osteoartritis de la Rodilla/fisiopatología , Catastrofización/psicología , Anciano , Persona de Mediana Edad , Dimensión del Dolor , Dolor Postoperatorio/psicología , Dolor Postoperatorio/etiología , Dolor Postoperatorio/fisiopatología , Estudios de Cohortes , Dolor/psicología , Dolor/fisiopatologíaRESUMEN
INTRODUCTION: Effective pain and anxiety management during the perioperative phase remains a challenge for patients undergoing surgeries and other invasive procedures. The current standard of care involves prescribing analgesics to treat these conditions; however, there has been recent interest in applying multimodal strategies that limit the use of these medications. One such modality is meditation, which has been shown to be effective in alleviating various physical and psychological symptoms in other settings. This systematic review aims to assess how current meditative practices affect perioperative pain and anxiety. METHODS: We conducted a systematic review of randomized controlled trials following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search was conducted using PubMed MEDLINE, Embase, PsycINFO, APA PsycINFO, EBM Reviews, Scopus, and Web of Science for all available dates. Our primary outcomes of interest were patient-reported pain and anxiety scores using the Visual Analog Scale, the Brief Pain Inventory, the Depression Anxiety Stress Scale, the State-Trait Anxiety Inventory (STAI), and the Hospital Anxiety and Depression Scale (HADS). For the HADS and STAI scales, only the anxiety and anxiety-state subgroups were reported, respectively. RESULTS: The literature search yielded 1746 articles. A total of 286 full-text articles were screened, and 16 studies were included in this systematic review. A total of eight studies assessed pain scores after invasive procedures; five reported improvements in pain scores, and three reported no change after meditative practices. Ten studies assessed anxiety outcomes after invasive procedures: nine reported a decrease in overall anxiety levels as a result of meditation practices while one study reported no change in anxiety scores. CONCLUSION: Data from this limited literature suggests that different meditation practices could be effective in alleviating pain and anxiety within the perioperative phase for patients undergoing various types of invasive procedures. Future prospective studies are needed to determine whether routine meditation in the perioperative setting is effective in mitigating perioperative pain and anxiety.
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Ansiedad , Meditación , Manejo del Dolor , Humanos , Meditación/métodos , Ansiedad/terapia , Manejo del Dolor/métodos , Dolor Postoperatorio/terapia , Dolor Postoperatorio/psicología , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
Nonpharmacological methods are used in the management of pain and kinesiophobia following total knee arthroplasty. The aim of this double-blind randomized controlled trial was to examine the effect of foot reflexology on pain and kinesiophobia in patients following total knee arthroplasty. A total of 40 patients (20 in the control group and 20 in the intervention group) were randomly assigned to either of two groups for the study. The intervention group was exposed to foot reflexology. Postoperative Visual Analog Scale scores decreased faster in the intervention group compared to the control group (F = 80.417; p < .001; η2 = 0.685). The Western Ontario and McMaster Universities Osteoarthritis Index scores decreased in the intervention group over time, while they increased in the control group (p < .05). While a gradual increase was observed in the Tampa Scale for Kinesiophobia scores in the control group, there was a decrease in the intervention group (F = 84.860; p < .001; η2 = 0.696). The amount of analgesics used was lower in the intervention group (p < .05). Foot reflexology can be applied as an effective and safe method to manage pain and kinesiophobia in total knee arthroplasty patients.
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Artroplastia de Reemplazo de Rodilla , Pie , Humanos , Artroplastia de Reemplazo de Rodilla/efectos adversos , Artroplastia de Reemplazo de Rodilla/psicología , Método Doble Ciego , Masculino , Femenino , Pie/cirugía , Persona de Mediana Edad , Dimensión del Dolor/métodos , Dolor Postoperatorio/psicología , Dolor Postoperatorio/etiología , Dolor Postoperatorio/terapia , Anciano , Manejo del Dolor/métodos , Masaje/métodos , Masaje/psicología , KinesiofobiaRESUMEN
BACKGROUND: Dermatosurgical procedures are predominantly performed under local anesthesia, yet there are few studies on perioperative pain management for extensive or staged procedures under local anesthesia. The purpose of this study was to assess pain during dermatologic surgery, describe perioperative pain management, and identify factors that influence pain perception. PATIENTS AND METHODS: This prospective, monocentric study included inpatients undergoing dermatologic surgery under local anesthesia from April to December 2021. Preoperative demographic data, a pain questionnaire, and four psychometric questionnaires (PCS, LOT-R, SFQ, PHQ-9) were collected. Postoperative pain and analgesic use during the first 24 hours were recorded. RESULTS: A total of 120 patients (with a total of 191 interventions) were included in the study. Mean postoperative pain was reported to be very low (NRS < 2). Preoperative pain and expected postoperative pain were found to be predictive of postoperative pain. There was a strong correlation between catastrophizing and preoperative anxiety (r = 0.65) and a moderate correlation between depression and preoperative anxiety (r = 0.46). CONCLUSIONS: Dermatologic surgery under local anesthesia is generally considered painless. During preoperative counseling and assessment, attention should be paid to patients who fear surgery, report pain, or anticipate postoperative pain, as they have an increased risk of experiencing postoperative pain.
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Anestesia Local , Procedimientos Quirúrgicos Dermatologicos , Percepción del Dolor , Dolor Postoperatorio , Humanos , Estudios Prospectivos , Femenino , Masculino , Dolor Postoperatorio/psicología , Persona de Mediana Edad , Procedimientos Quirúrgicos Dermatologicos/efectos adversos , Procedimientos Quirúrgicos Dermatologicos/psicología , Anciano , Adulto , Dimensión del Dolor , Ansiedad/psicología , Manejo del Dolor/métodos , Encuestas y Cuestionarios , Analgésicos/uso terapéutico , Anciano de 80 o más AñosRESUMEN
BACKGROUND: Psychological factors such as anxiety and mood appear to influence acute postoperative pain; however, there is conflicting evidence on the relationship between preoperative psychological parameters and the severity of postoperative pain. In the context of the stressful setting of initial surgery for breast cancer, we conducted a prospective observational study of patients who were scheduled to undergo initial breast cancer surgery. METHODS: The objectives were to examine the potential associations between predefined preoperative psychological parameters and (i) Self-reported pain scores at discharge from the postoperative acute care unit, (ii) Cumulative perioperative opioid consumption at four hours postoperatively and (iii) Self-reported pain as measured during the first seven days after surgery. Patients completed the following questionnaires during the three hours prior to surgery: the Spielberger State Trait Anxiety Inventory (STAI State and Trait), the Pain Catastrophizing Scale (PCS), the Cohen Stress Questionnaire (CSQ), the Hospital Anxiety and Depression Scale (HADS A and D), and the short-form McGill Pain Questionnaire. Postoperative pain experience was assessed using patient self-reports of pain (SF Magill Pain questionnaire on discharge from the postanaesthesia care unit and a pain diary for seven days postoperatively) and records of analgesic consumption. RESULTS: Pre- to postoperative self-reported pain was significantly different with respect to the STAI State, Cohen score and PCS for both low and high values (p < 0.001), but only patients categorized as having low STAI Trait, HADS A, and HADS D values achieved significant differences (p < 0.001). A significant positive correlation was demonstrated between preoperative state anxiety (STAI) and the most severe pain reported during the first seven days postoperatively (r = 0.271, p = 0.013). Patients who were categorized preoperatively as having a "high value" for each of the psychological parameters studied (HADS A and D, STAI State and Trait and PCS) tended to have greater perioperative opioid consumption (up to four hours postoperatively); this trend was statistically significant for HADS D and HADS A only. Using a linear regression model, state anxiety was found to be a significant predictor of postoperative pain based on self-reports during the first seven postoperative days (standardized ß = 0.271, t = 2.286, p = 0.025). CONCLUSION: Preoperative state anxiety, in particular, is associated with the severity of postoperative pain experienced by women undergoing initial breast cancer surgery. Formal preoperative assessment of anxiety may be warranted in this setting with a view to optimize perioperative analgesia and wellbeing.
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Ansiedad , Neoplasias de la Mama , Dimensión del Dolor , Dolor Postoperatorio , Autoinforme , Humanos , Dolor Postoperatorio/psicología , Dolor Postoperatorio/tratamiento farmacológico , Femenino , Neoplasias de la Mama/cirugía , Neoplasias de la Mama/psicología , Persona de Mediana Edad , Estudios Prospectivos , Ansiedad/psicología , Dimensión del Dolor/métodos , Anciano , Analgésicos Opioides/uso terapéutico , Analgésicos Opioides/administración & dosificación , Periodo Preoperatorio , Adulto , Encuestas y Cuestionarios , Analgésicos/uso terapéutico , Analgésicos/administración & dosificaciónRESUMEN
OBJECTIVE: To evaluate the efficacy and quality of life in long-term period (1 year) after total knee replacement in various age groups. MATERIAL AND METHODS: We studied 134 patients after unilateral primary total knee replacement. The KOOS and SF-36 questionnaires were used to assess the therapeutic effect (functionality and symptoms) and quality of life in patients with knee osteoarthritis. RESULTS: At baseline, group I (young patients) had low KOOS pain scores (39.42±16.42), function scores (50.18±19.16) and QoL scores (18.2±15.9) compared to other age groups. A year after surgery, group I (<55 years) had significantly lower KOOS scores of pain, function and quality of life compared to group III (>65 years). Multiple regression analysis showed that age was a significant predictor of pain, but not a function after a year. CONCLUSION: Total knee replacement gives a noticeable improvement in pain, functionality and quality of life in all age groups. However, there are significant age-related differences in preoperative assessment of pain, quality of life and mental health, as well as in final indicators of postoperative pain and quality of life. Indeed, young patients (<50 years) report more intense pain and worse quality of life. These data may be used in clinical practice to improve decision-making and patient expectations before total knee replacement.
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Artroplastia de Reemplazo de Rodilla , Osteoartritis de la Rodilla , Calidad de Vida , Humanos , Artroplastia de Reemplazo de Rodilla/métodos , Artroplastia de Reemplazo de Rodilla/efectos adversos , Femenino , Masculino , Persona de Mediana Edad , Osteoartritis de la Rodilla/cirugía , Anciano , Factores de Edad , Dimensión del Dolor/métodos , Encuestas y Cuestionarios , Dolor Postoperatorio/etiología , Dolor Postoperatorio/diagnóstico , Dolor Postoperatorio/psicología , Resultado del Tratamiento , Recuperación de la FunciónRESUMEN
This prospective study aims to evaluate dental pain, anxiety, and catastrophizing levels in pregnant women undergoing root canal treatment. Sixty pregnant and non-pregnant women presenting dental pain and an indication for root canal treatment were included in the study. Dental anxiety and catastrophizing were investigated using validated questionnaires. The endodontic intervention was performed, and a numerical scale measured preoperative and postoperative dental pain. The results were analyzed using STATA software 12.0. Unadjusted analyses assessed the association between pregnancy and pain, anxiety, and catastrophizing levels. Multiple linear regression models using 'forward stepwise' entry procedures were used to assess the independent effects of variables on pain scores. The significance level was set at 0.05. Initially, most patients experienced intense dental pain. The levels of dental pain, dental anxiety, and catastrophizing did not differ between pregnant and non-pregnant women. Logistic regression showed that postoperative pain was associated with irreversible pulpitis diagnosis (OR = 4.78; 95%CI 1.55-13.55) and high catastrophizing levels (OR = 1.96; 95%CI 1.01-3.84). Preoperative and postoperative pain rates and anxiety and catastrophizing were similar between pregnant and non-pregnant patients. Postoperative pain was associated with irreversible pulpitis diagnosis and high catastrophizing levels. The similarity between pregnant and non-pregnant women regarding preoperative and postoperative dental pain and catastrophizing and anxiety levels supports the indication of root canal treatment during the gestational period whenever necessary.
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Catastrofización , Ansiedad al Tratamiento Odontológico , Dimensión del Dolor , Dolor Postoperatorio , Tratamiento del Conducto Radicular , Odontalgia , Humanos , Femenino , Tratamiento del Conducto Radicular/psicología , Embarazo , Adulto , Estudios Prospectivos , Ansiedad al Tratamiento Odontológico/psicología , Dolor Postoperatorio/psicología , Catastrofización/psicología , Adulto Joven , Odontalgia/psicología , Encuestas y Cuestionarios , Complicaciones del Embarazo/psicología , Modelos Logísticos , Pulpitis/psicología , Pulpitis/cirugía , Pulpitis/terapia , Estadísticas no ParamétricasRESUMEN
BACKGROUND: Pain and pain perception are influenced by patients' thoughts. The short form Negative Pain Thoughts Questionnaire (NPTQ-SF) can be used to quantify unhelpful negative cognitive biases about pain, but the relationship between NPTQ-SF scores and orthopaedic surgery outcomes is not known. PURPOSE/HYPOTHESIS: The purpose was to assess the relationship between negative pain thoughts, as measured by the NPTQ-SF, and patient-reported outcomes in patients undergoing arthroscopic rotator cuff repair, as well as to compare NPTQ-SF scores and outcomes between patients with and without a history of chronic pain and psychiatric history. It was hypothesized that patients with worse negative pain thoughts would have worse patient-reported outcomes. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: In total, 109 patients undergoing arthroscopic rotator cuff repair were administered the 4-item NPTQ-SF, 12-item Short Form Health Survey (SF-12), American Shoulder and Elbow Surgeons (ASES) Shoulder Evaluation Form, and visual analog scale pain survey preoperatively between July 2021 and August 2022. The same surveys were completed ≥6 months postoperatively by 74 patients confirmed to have undergone arthroscopic rotator cuff repair. RESULTS: Preoperative NPTQ-SF scores did not show any correlation with the postoperative patient-reported outcomes measured in this study. Postoperative NPTQ-SF scores were statistically significantly negatively correlated with postoperative SF-12 Physical Health Score, SF-12 Mental Health Score, ASES, and satisfaction scores (P < .05). Postoperative NPTQ-SF scores were statistically significantly positively correlated with postoperative visual analog scale scores (P < .001). Moreover, postoperative NPTQ-SF scores were statistically significantly negatively correlated with achieving a Patient Acceptable Symptom State and the minimal clinically important difference on the postoperative ASES form (P < .001 and P = .009, respectively). CONCLUSION: Postoperative patient thought patterns and their perception of pain are correlated with postoperative outcomes after rotator cuff repair. This correlation suggests a role for counseling and expectation management in the postoperative setting. Conversely, preoperative thought patterns regarding pain, as measured by the NPTQ-SF, do not correlate with postoperative patient-reported outcome measures. Therefore, the NPTQ-SF should not be used as a preoperative tool to aid the prediction of outcomes after rotator cuff repair.
Asunto(s)
Artroscopía , Medición de Resultados Informados por el Paciente , Lesiones del Manguito de los Rotadores , Humanos , Persona de Mediana Edad , Femenino , Masculino , Lesiones del Manguito de los Rotadores/cirugía , Anciano , Dolor Postoperatorio/psicología , Dimensión del Dolor , Encuestas y Cuestionarios , Adulto , Estudios de CohortesRESUMEN
AIM: The aim of this study was to examine the relationship between cognitive intrusion of pain, fear of surgery, and comfort in the perioperative period. DESIGN: This was a descriptive study conducted with 180 patients hospitalized for surgery in a training and research hospital. METHODS: A sociodemographic questionnaire, Surgical Fear Questionnaire, General Comfort Questionnaire, and Experience of Cognitive Intrusion of Pain Scale were administered to the participants prior to surgery, while General Comfort Questionnaire and Experience of Cognitive Intrusion of Pain Scale were administered after surgery. RESULTS: Of the participants with a mean age of 49.94 ± 17.26 years, 62.2% were male and 31.1% had at least one chronic disease. The mean preoperative and postoperative pain scores were 2.65 and 3.47, respectively. There was a statistically significant negative correlation between perioperative experience of cognitive intrusion of pain and perioperative comfort and a positive correlation between perioperative experience of cognitive intrusion of pain and preoperative fear of surgery (p < .05). CONCLUSIONS: Cognitive intrusion of pain does not change in the perioperative period. As the cognitive intrusion of pain increases, patient comfort decreases and surgical fear increases. Our study contributes to the literature since it is the first study evaluating the cognitive intrusion of pain in the perioperative period.
Asunto(s)
Miedo , Humanos , Masculino , Femenino , Persona de Mediana Edad , Miedo/psicología , Adulto , Encuestas y Cuestionarios , Anciano , Dimensión del Dolor/métodos , Dolor Postoperatorio/psicología , Cognición , Comodidad del Paciente/normas , Comodidad del Paciente/métodos , Comodidad del Paciente/estadística & datos numéricosRESUMEN
OBJECTIVES: To explore people's views of recovery from total knee replacement (TKR) and which recovery domains they felt were important. DESIGN: Semi-structured interviews exploring the views of individuals about to undergo or who have undergone TKR. A constant-comparative approach with thematic analysis was used to identify themes. The process of sampling, collecting data and analysis were continuous and iterative throughout the study, with interviews ceasing once thematic saturation was achieved. SETTING: Tertiary care centre. PARTICIPANTS: A purposive sample was used to account for variables including pre, early or late postoperative status. RESULTS: 12 participants were interviewed, 4 who were preoperative, 4 early postoperative and 4 late postoperative. Themes of pain, function, fear of complications, awareness of the artificial knee joint and return to work were identified. Subthemes of balancing acute and chronic pain were identified. CONCLUSIONS: The results of this interview-based study identify pain and function, in particular mobility, that were universally important to those undergoing TKR. Surgeons should consider exploring these domains when taking informed consent to enhance shared decision-making. Researchers should consider these recovery domains when designing interventional studies.
Asunto(s)
Artroplastia de Reemplazo de Rodilla , Entrevistas como Asunto , Investigación Cualitativa , Recuperación de la Función , Humanos , Artroplastia de Reemplazo de Rodilla/rehabilitación , Artroplastia de Reemplazo de Rodilla/psicología , Femenino , Masculino , Anciano , Persona de Mediana Edad , Reinserción al Trabajo , Anciano de 80 o más Años , Osteoartritis de la Rodilla/cirugía , Dolor Postoperatorio/psicologíaRESUMEN
Opioids are frequently prescribed for patients undergoing procedures such as spinal fusion surgery for the management of chronic back pain. However, the association between a preoperative mental health illness, such as depression or anxiety, and opioid use patterns after spinal fusion surgery remain unclear. Therefore, we performed a systematic literature review in accordance with PRISMA guidelines to identify articles from the PubMed Database that analyzed the relationship between preoperative mental health illness and postoperative opioid usage after spinal fusion surgery on June 1, 2023. The Methodological Index for Nonrandomized Studies (MINORS) was utilized to evaluate the quality of included articles. Seven studies with 139,580 patients and a mean MINORS score of 18 ± 0.5 were included in qualitative synthesis. The most common spine surgery performed was lumbar fusion (59 %) and the mean age across studies ranged from 50 to 62 years. The range of postoperative opioid usage patterns analyzed ranged from 1 to 24 months. The majority of studies (6/7; 86 %) reported that a preoperative diagnosis of mental health illness was associated with increased opioid dependence after spinal fusion surgery. Preoperative use of opioids for protracted periods was shown to be associated with postoperative chronic opioid dependence. Consensus findings suggest that having a preoperative diagnosis of a mental health illness such as depression or anxiety is associated with increased postoperative opioid use after spinal fusion surgery. Patient comorbidities, including diagnoses of mental health illness, must be considered by the spine surgeon in order to reduce rates of postoperative opioid dependence.