Do psychological variables affect early surgical recovery?
Open accessAbstract
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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Cites
Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation
Beck, A. T., Steer, R. A., & Carbin, M. G. (1988) · Clinical Psychology Review · doi:10.1016/0272-7358(88)90050-5 · Cited by 11,696 · see citing works
View Through a Window May Influence Recovery from Surgery
Ulrich, R. S. (1984) · Science · doi:10.1126/science.6143402 · Cited by 5,341 · see citing works
The Revised UCLA Loneliness Scale: concurrent and discriminant validity evidence
Russell, D., Peplau, L. A., & Cutrona, C. E. (1980) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.39.3.472 · Cited by 5,173 · see citing works
Psychological stress and the human immune system: a meta-analytic study of 30 Years of inquiry
Segerstrom, S. C., & Miller, G. E. (2004) · Psychological Bulletin · doi:10.1037/0033-2909.130.4.601 · Cited by 3,334 · see citing works
Positive emotions in early life and longevity: Findings from the nun study.
Danner, D. D., Snowdon, D. A., & Friesen, W. V. (2001) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.80.5.804 · Cited by 1,406 · see citing works
Slowing of wound healing by psychological stress
Kiecolt-Glaser, J. K., Marucha, P. T., Mercado, A. M., Malarkey, W. B., & Glaser, R. (1995) · The Lancet · doi:10.1016/s0140-6736(95)92899-5 · Cited by 1,104 · see citing works
Lespérance, F., Frasure‐Smith, N., Talajic, M. R., & Bourassa, M. G. (2002) · Circulation · doi:10.1161/hc0902.104707 · Cited by 722 · see citing works
Hostile Marital Interactions, Proinflammatory Cytokine Production, and Wound Healing
Kiecolt-Glaser, J. K., Loving, T. J., Stowell, J. R., Malarkey, W. B., Lemeshow, S., Dickinson, S. L., & Glaser, R. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.12.1377 · Cited by 715 · see citing works
Psychological influences on surgical recovery: Perspectives from psychoneuroimmunology.
Kiecolt-Glaser, J. K., Page, G. G., Marucha, P. T., MacCallum, R. C., & Glaser, R. (1998) · American Psychologist · doi:10.1037/0003-066x.53.11.1209 · Cited by 605 · see citing works
Active Coping Processes, Coping Dispositions, and Recovery from Surgery
Cohen, F., & Lazarus, R. S. (1973) · Psychosomatic Medicine · doi:10.1097/00006842-197309000-00002 · Cited by 520 · see citing works
Mucosal Wound Healing Is Impaired by Examination Stress
Marucha, P. T., Kiecolt‐Glaser, J. K., & Favagehi, M. (1998) · Psychosomatic Medicine · doi:10.1097/00006842-199805000-00025 · Cited by 492 · see citing works
Mumford, E., Schlesinger, H. J., & Glass, G. V. (1982) · American Journal of Public Health · doi:10.2105/ajph.72.2.141 · Cited by 455 · see citing works
Psychosocial Factors and Surgical Outcomes: An Evidence-Based Literature Review
Rosenberger, P. H., Jokl, P., & Ickovics, J. R. (2006) · Journal of the American Academy of Orthopaedic Surgeons · doi:10.5435/00124635-200607000-00002 · Cited by 407 · see citing works
Smith, T. W., & Ruiz, J. M. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.70.3.548 · Cited by 362 · see citing works
Effects of psychoeducational care for adult surgical patients: A meta-analysis of 191 studies
Devine, E. C. (1992) · Patient Education and Counseling · doi:10.1016/0738-3991(92)90193-m · Cited by 360 · see citing works
Benefits of Psychological Preparation for Surgery: a Meta-Analysis
Johnston, M., & Vögele, C. (1993) · Annals of Behavioral Medicine · doi:10.1093/abm/15.4.245 · Cited by 345 · see citing works
Stress-Related Changes in Proinflammatory Cytokine Production in Wounds
Glaser, R., Kiecolt‐Glaser, J. K., Marucha, P. T., MacCallum, R. C., Laskowski, B. F., & Malarkey, W. B. (1999) · Archives of General Psychiatry · doi:10.1001/archpsyc.56.5.450 · Cited by 344 · see citing works
Smith, T. W., & Ruiz, J. M. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.70.3.548 · Cited by 278 · see citing works
Munafo, M. R., & Stevenson, J. (2001) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(01)00258-6 · Cited by 256 · see citing works
Psychological Stress Impairs Early Wound Repair Following Surgery
Broadbent, E., Petrie, K. J., Alley, P. G., & Booth, R. J. (2003) · Psychosomatic Medicine · doi:10.1097/01.psy.0000088589.92699.30 · Cited by 247 · see citing works
Depression and anxiety and outcomes of coronary artery bypass surgery
Pignay-Demaria, V., Lespérance, F., Demaria, R., Frasure‐Smith, N., & Perrault, L. P. (2003) · The Annals of Thoracic Surgery · doi:10.1016/s0003-4975(02)04391-6 · Cited by 214 · see citing works
Contrada, R. J., Goyal, T. M., Cather, C., Rafalson, L., Idler, E. L., & Krause, T. J. (2004) · Health Psychology · doi:10.1037/0278-6133.23.3.227 · Cited by 205 · see citing works
The effect of psychosocial factors on breast cancer outcome: a systematic review
Falagas, M. E., Zarkadoulia, E. A., Ioannidou, E., Peppas, G., Christodoulou, C., & Rafailidis, P. I. (2007) · Breast Cancer Research · doi:10.1186/bcr1744 · Cited by 203 · see citing works
Self-citationEffects of relaxation with guided imagery on surgical stress and wound healing
Holden‐lund, C. (1988) · Research in Nursing & Health · doi:10.1002/nur.4770110405 · Cited by 178 · see citing works
Evans, C. A., & Richardson, P. H. (1988) · The Lancet · doi:10.1016/s0140-6736(88)90131-6 · Cited by 157 · see citing works
Personality and surgical recovery: A review
Mathews, A., & Ridgeway, V. A. (1981) · British Journal of Clinical Psychology · doi:10.1111/j.2044-8260.1981.tb00525.x · Cited by 144 · see citing works
1. A review of the impact of pre-operative education on recovery from surgery
Shuldham, C. M. (1999) · International Journal of Nursing Studies · doi:10.1016/s0020-7489(99)00010-3 · Cited by 136 · see citing works
Psychological preparation for invasive medical and dental procedures
Anderson, K. O., & Masur, F. T. (1983) · Journal of Behavioral Medicine · doi:10.1007/bf00845274 · Cited by 135 · see citing works
Stress management during noxious medical procedures: An evaluative review of outcome studies.
Ludwick-Rosenthal, R., & Neufeld, R. W. J. (1988) · Psychological Bulletin · doi:10.1037/0033-2909.104.3.326 · Cited by 108 · see citing works
Effects of psychophysical stress on surgical outcome.
Linn, B. S., Linn, M. W., & Klimas, N. G. (1988) · Psychosomatic Medicine · doi:10.1097/00006842-198805000-00002 · Cited by 93 · see citing works
Depressive Symptoms Predict Mucosal Wound Healing
Bosch, J. A., Engeland, C. G., Cacioppo, J. T., & Marucha, P. T. (2007) · Psychosomatic Medicine · doi:10.1097/psy.0b013e318148c682 · Cited by 91 · see citing works
The effects of psychological factors and physical trauma on recovery from oral surgery
George, J. M., Scott, D. S., Turner, S. P., & Gregg, J. M. (1980) · Journal of Behavioral Medicine · doi:10.1007/bf00845053 · Cited by 89 · see citing works
Rosmarakis, E. S., Soteriades, E. S., Vergidis, P. I., Kasiakou, S. K., & Falagas, M. E. (2005) · The FASEB Journal · doi:10.1096/fj.04-3140lfe · Cited by 83 · see citing works
Self-citationPeer Support. An Under-Recognized Resource in Cardiac Recovery
Colella, T. J. F., & King, K. M. (2004) · European Journal of Cardiovascular Nursing · doi:10.1016/j.ejcnurse.2004.04.001 · Cited by 74 · see citing works
The influence of anger expression on wound healing
Gouin, J., Kiecolt‐Glaser, J. K., Malarkey, W. B., & Glaser, R. (2007) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2007.10.013 · Cited by 70 · see citing works
The Efficacy of the Relaxation Response in Preparing for Cardiac Surgery
Leserman, J., Stuart‐Shor, E., Mamish, M. E., & Benson, H. (1989) · Behavioral Medicine · doi:10.1080/08964289.1989.9934573 · Cited by 64 · see citing works
The prediction of cardiac surgery outcome based upon preoperative psychological factors
Stengrevics, S. S., Sirois, C. A., Schwartz, C. E., Friedman, R. B., & Domar, A. D. (1996) · Psychology and Health · doi:10.1080/08870449608401983 · Cited by 55 · see citing works
Building Emotional Resilience to Promote Health
Davis, M. C. (2009) · American Journal of Lifestyle Medicine · doi:10.1177/1559827609335152 · Cited by 50 · see citing works
Schindler, B. A., Shook, J., & Schwartz, G. M. (1989) · General Hospital Psychiatry · doi:10.1016/0163-8343(89)90124-2 · Cited by 43 · see citing works
Psychosocial factors and susceptibility to or outcome of acute respiratory tract infections.
Falagas, M. E., Karamanidou, C., Kastoris, A. C., Karlis, G., & Rafailidis, P. I. (2010) · PubMed · Cited by 41 · see citing works
Self-citationPreoperative State of Mind Among Patients Undergoing CABG
Halpin, L. S., & Barnett, S. D. (2005) · Journal of Nursing Care Quality · doi:10.1097/00001786-200501000-00012 · Cited by 22 · see citing works
Psychological factors, immune function and recovery from major surgery
Vollmer-Conna, U. S., Bird, K. D., Yeo, B. W., Truskett, P. G., Westbrook, R. F., & Wakefield, D. (2009) · Acta Neuropsychiatrica · doi:10.1111/j.1601-5215.2009.00398.x · Cited by 13 · see citing works
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Tefikow, S., Barth, J., Maichrowitz, S., Beelmann, A., Strauss, B., & Rosendahl, J. (2013) · Clinical Psychology Review · doi:10.1016/j.cpr.2013.03.005 · Cited by 170 · see citing works
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- Authors
- Mavros, M. N., Athanasiou, S., Gkegkes, I. D., Polyzos, K. A., Peppas, G., & Falagas, M. E.
- Affiliations
- National and Kapodistrian University of Athens (GR)
- Alfa Institute of Biomedical Sciences (GR)
- Henry Dunant Hospital (GR)
- Tufts University (US)
- Corresponding author
- Falagas, Matthew E.
- ORCID
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2011-05-25
- Volume
- 6
- Issue
- 5
- Pages
- e20306
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3102096
- OpenAlex
- W2072177902
- Cited by
- 229
- References
- 42
- Citations by year
- 2026: 20 · 2025: 18 · 2024: 17 · 2023: 23 · 2022: 15 · 2021: 21 · 2020: 31 · 2019: 12 · 2018: 10 · 2017: 12 · 2016: 15 · 2015: 10 · 2014: 6 · 2013: 8 · 2012: 8
- FWCI
- 8.19
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Social Sciences › Psychology › Social Psychology › Music Therapy and Health
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Keywords
- psychological factors, postoperative recovery, early postoperative outcomes, preoperative anxiety, depression, optimism, religiosity, coping, pain anticipation, locus of control, anger, psychological intervention, guided relaxation, partner support, psychiatric interview, loneliness, social support
- MeSH terms
- Adaptation, Psychological, Humans, Postoperative Care, Preoperative Care, Social Support, Stress, Psychological, Surgical Procedures, Operative, Wound Healing, Treatment Outcome
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