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Walton LL, Duff E, Arora RC, McMillan DE. The Role of the Cardiac Surgery Patient in Pain Management: The Patient Perspective. Clin Nurs Res 2024:10547738241273232. [PMID: 39169478 DOI: 10.1177/10547738241273232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
One and a half million cardiac surgeries are completed worldwide each year where undertreated postoperative pain increases the risk of patient morbidity and mortality. Patient-centered pain management is recommended to improve patient outcomes but there is insufficient information regarding how the patient views their role. The objective of this study is to explore cardiac surgery patients' perspectives on their role in postoperative pain management. This study used an interpretive phenomenological design and convenience sampling. Six participants who had undergone cardiac surgery were recruited from a cardiac rehabilitation program in Western Canada. The first author conducted semi-structured digitally recorded interviews. Sociodemographic characteristics and measures of anxiety and depression were also collected. Emergent thematic analysis of the qualitative data generated three themes: attitude, coping and care, and communication. The findings of this study address a gap in the literature with regard to patients' perceived roles in pain management. There is a complex relationship between patient attitude, coping and care, and communication which, in turn, influences how patients view their role within the pain management continuum. These themes contribute to the development of the patient role within the pain management continuum and form an integrated feedback loop. The patient's attitude contributes to their ability to cope with pain and participate in pain assessment and management. Furthermore, their ability to cope and desire to participate influences the development of their attitude. These findings may enhance providers' understanding of the patient's perspective and improve pain management outcomes.
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Affiliation(s)
- Laura L Walton
- College of Nursing, University of Manitoba, Winnipeg, Canada
- Pan Am Clinic, Winnipeg, Manitoba, Canada
| | - Elsie Duff
- College of Nursing, University of Manitoba, Winnipeg, Canada
| | - Rakesh C Arora
- Department of Surgery, College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Diana E McMillan
- College of Nursing, University of Manitoba, Winnipeg, Canada
- Clinical Chair Program, Health Sciences Centre, Winnipeg, Canada
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Cheng M, Liu H, Pu C, Chen G, Zhang Y, Yan L. Catastrophic Cognition Is a Stronger Predictor Than Emotional Factors of Acute Postoperative Pain in Patients With Traumatic Orthopedic Injuries. Pain Manag Nurs 2024:S1524-9042(24)00192-9. [PMID: 39097418 DOI: 10.1016/j.pmn.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 05/23/2024] [Accepted: 06/04/2024] [Indexed: 08/05/2024]
Abstract
BACKGROUND Both cognitive (pain catastrophizing [PC]) and emotional factors (anxiety, depression, and optimism) play vital roles in acute postoperative pain (APOP) management among patients with traumatic orthopedic injuries (TOIs). It remains uncertain if these psychological factors independently or collectively impact APOP in patients with TOIs, and the underlying mechanisms by which various psychological factors impact APOP in patients with TOIs are also ambiguous. PURPOSE The aims of the current research were to analyze the effects of PC and emotional factors (anxiety, depression, and optimism) on APOP in patients with TOIs and explore the potential mechanisms by which PC and emotional factors influence APOP based on a hypothetical moderated mediation pathway mediated by pain-related fear. METHODS This was an observational cross-sectional study. RESULTS PC was a significantly positive predictor of APOP regardless of coexistence with emotional factors. TOI patients who had higher PC had more severe APOP (β = 0.57, standard error [SE] = 0.005, p < .01, adjusted R2 = 0.78; β = 0.84, SE = 0.003, p < .01, adjusted R2 = 0.77, respectively). Furthermore, when positive and negative emotions coexisted (adjusted R2 = 0.74), anxiety levels were a significant positive predictor of APOP (β = 0.71, SE = 0.009, p < .01) and optimism was a significant negative predictor of APOP (β = -0.24, SE = 0.008, p < .01). Pain-related fear played a mediating role in the association between the level of PC (effect = 0.044, 95% confidence interval [CI] = 0.027 to 0.062), anxiety (effect = 0.102, 95% CI = 0.075 to 0.137), and APOP in patients with TOIs. Optimism moderated the strength of the relationship between PC (95% CI = -0.020 to -0.010), anxiety (95% CI = -0.045 to -0.003), and APOP mediated by pain-related fear. CONCLUSIONS Clinical staff should assess the level of PC and emotional factors to identify TOI patients at high risk for APOP, subsequently facilitating the optimization of pain management and efficient utilization of nursing resources through early discussion.
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Affiliation(s)
- Ming Cheng
- Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
| | - Huan Liu
- Orthopedics Department, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
| | - Chenxi Pu
- Orthopedics Department, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Guoying Chen
- Orthopedics Department, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yaer Zhang
- Orthopedics Department, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Li Yan
- Orthopedics Department, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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Liu QR, Dai YC, Ji MH, Liu PM, Dong YY, Yang JJ. Risk Factors for Acute Postsurgical Pain: A Narrative Review. J Pain Res 2024; 17:1793-1804. [PMID: 38799277 PMCID: PMC11122256 DOI: 10.2147/jpr.s462112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/10/2024] [Indexed: 05/29/2024] Open
Abstract
Acute postsurgical pain (APSP) has received growing attention as a surgical outcome. When poorly controlled, APSP can affect short- and long-term outcomes in patients. Despite the steady increase in awareness about postoperative pain and standardization of pain prevention and treatment strategies, moderate-to-severe APSP is frequently reported in clinical practice. This is possibly because pain varies widely among individuals and is influenced by distinct factors, such as demographic, perioperative, psychological, and genetic factors. This review investigates the risk factors for APSP, including gender, age, obesity, smoking history, preoperative pain history, pain sensitivity, preoperative anxiety, depression, pain catastrophizing, expected postoperative pain, surgical fear, and genetic polymorphisms. By identifying patients having an increased risk of moderate-to-severe APSP at an early stage, clinicians can more effectively manage individualized analgesic treatment protocols with a combination of pharmacological and non-pharmacological interventions. This would alleviate the transition from APSP to chronic pain and reduce the severity of APSP-induced chronic physical disability and social psychological distress.
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Affiliation(s)
- Qing-Ren Liu
- Department of Anesthesiology, Xishan People’s Hospital of Wuxi City, Wuxi, 214105, People’s Republic of China
| | - Yu-Chen Dai
- Department of Anesthesiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, 210009, People’s Republic of China
| | - Mu-Huo Ji
- Department of Anesthesiology, The Second Affiliated Hospital, Nanjing Medical University, Nanjing, 210011, People’s Republic of China
| | - Pan-Miao Liu
- Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, People’s Republic of China
| | - Yong-Yan Dong
- Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, People’s Republic of China
| | - Jian-Jun Yang
- Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, People’s Republic of China
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Dağcan N, Özden D, Gürol Arslan G. Pain perception of patients in intensive care unit after cardiac surgery: A qualitative study using Roy's Adaptation Model. Nurs Crit Care 2024; 29:512-520. [PMID: 37527978 DOI: 10.1111/nicc.12958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/24/2023] [Accepted: 07/14/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Although research on postoperative pain has increased, postoperative pain management is still a problem today. Most patients experience moderate to severe pain after cardiac surgery. As a result of pain, patients show inefficient adaptation behaviour in physiologic, role function, self-concept, and interdependence modes. AIM This study was conducted to examine the pain perceptions of intensive care patients after cardiac surgery according to Roy's Adaptation Model (RAM). STUDY DESIGN A qualitative design with a phenomenological approach was used in the study. The research data were collected by using a "descriptive information form", a "semi-structured interview form", and the "numerical rating scale" through the "in-depth interview method". The study sample consisted of 16 patients who were aged 18 years or older, had undergone cardiac surgery, experienced pain post-operatively in the intensive care unit at least once, and had intensive care experience. Patients with neuropathic or chronic pain or neurological or psychiatric disorders were not included in the study. Data were classified into physiologic, self-concept, and interdependence modes according to RAM. RESULTS The themes and sub-themes that emerged included physiologic modes (pain responses), self-concept modes (pain self-management), role-function modes (effects of pain), and interdependence modes (support systems in pain). CONCLUSIONS The results of our study can enable patients and nurses to communicate effectively about pain. In future studies, the effect of model-based pain management programs on cardiac surgery patients can be investigated. RELEVANCE TO CLINICAL PRACTICE Examining the pain perceptions of intensive care patients after cardiac surgery according to RAM will guide the improvement and development of pain management. It is thought that the model addresses intensive care patients experiencing pain holistically.
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Affiliation(s)
- Necibe Dağcan
- Nursing Department, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Dilek Özden
- Fundamentals of Nursing Department, Nursing Faculty, Dokuz Eylul University, Izmir, Turkey
| | - Gülşah Gürol Arslan
- Fundamentals of Nursing Department, Nursing Faculty, Dokuz Eylul University, Izmir, Turkey
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Dağcan Şahin N, Gürol Arslan G. Perspectives of patients, families and nurses on pain after cardiac surgery: A qualitative study. Nurs Crit Care 2024; 29:501-511. [PMID: 37970732 DOI: 10.1111/nicc.13000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Post-cardiac surgery pain affects patients, family caregivers and nurses. The pain experiences of patients, caregivers and nurses remain largely unknown. Therefore, it is important to examine the experiences of patients, caregivers and nurses in depth to ensure effective pain management. AIM The aim of this study is to examine post-cardiac surgery pain from the perspectives of patients, caregivers and nurses. STUDY DESIGN A descriptive qualitative research design was used. The study was carried out in the cardiovascular surgery ward of a tertiary hospital in Türkiye between June and December 2022. The data-driven triangulation method was used in the research. The study sample consisted of eight patients who had undergone cardiac surgery in the tertiary hospital, eight family caregivers and nine nurses who provided care for these individuals. A 'semi-structured interview form' was used to collect data through face-to-face and in-depth interviews. The data were analysed using the thematic analysis method. The COREQ checklist was used for reporting the study. RESULTS As a result of the interviews, six themes were elicited from the data. These themes were 'explaining pain', 'assessment of pain', 'responses to pain', 'effect of pain on activities of daily living', 'expectations in painful situations' and 'pain management'. CONCLUSIONS This study revealed the differences between pain perceptions and coping processes of patients who experienced pain after cardiac surgery, their caregivers and nurses. RELEVANCE TO CLINICAL PRACTICE Considering the experiences of patients, caregivers and nurses in pain management after cardiac surgery, applications that will ensure joint participation in care practices should be planned.
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Affiliation(s)
- Necibe Dağcan Şahin
- Fundamentals of Nursing Department, The Institute of Health Sciences, Dokuz Eylül University, Izmir, Türkiye
| | - Gülşah Gürol Arslan
- Fundamentals of Nursing Department, Nursing Faculty, Dokuz Eylül University, Izmir, Türkiye
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Wang L, Qin F, Liu H, Lu XH, Zhen L, Li GX. Pain Sensitivity and Acute Postoperative Pain in Patients Undergoing Abdominal Surgery: The Mediating Roles of Pain Self-Efficacy and Pain Catastrophizing. Pain Manag Nurs 2024; 25:e108-e114. [PMID: 38184383 DOI: 10.1016/j.pmn.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 11/25/2023] [Accepted: 12/02/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Inadequately managed postoperative pain remains a common issue. Examining factors like pain sensitivity, pain catastrophizing, and pain self-efficacy can help improve postoperative pain management. While these factors have been identified as potential predictors of acute postoperative pain, their effects have been inconsistent. Few studies have explored the interactions between these factors. AIM To investigate the influence of preoperative pain sensitivity, pain catastrophizing, and pain self-efficacy on acute postoperative pain in abdominal surgery patients and to determine the mediating roles of pain catastrophizing and pain self-efficacy in the relationship between pain sensitivity and acute postoperative pain, as per the gate control theory. METHODS A total of 246 patients were enrolled in this study. General information was collected before surgery, and the Pain Sensitivity Questionnaire (PSQ), Pain Catastrophizing Scale (PCS), and Pain Self-Efficacy Questionnaire (PSEQ) were administered. After surgery, patients' average pain scores over the 24 hours were reported using the Numerical Rating Scale (NRS). Correlation analyses and a structural equation model were used to examine the relationships among these variables. RESULTS NRS scores over 3 during the 24 hours post-surgery were reported by 21.54% of patients. Postoperative acute pain was found to be associated with pain sensitivity (rs = 0.463, p < .001), pain catastrophizing (rs = 0.328, p < .001), and pain self-efficacy (rs = -0.558, p < .001). A direct effect on postoperative acute pain was exerted by pain sensitivity (effect = 0.250, p = .001), along with indirect effects through: (A) pain catastrophizing (effect = 0.028, p = .001); (B) pain self-efficacy (effect = 0.132, p = .001); and (C) the chain mediation of pain self-efficacy and pain catastrophizing (effect = 0.021, p = .008). CONCLUSIONS The severity of postoperative acute pain can be predicted by pain self-efficacy and pain catastrophizing, and the connection between moderate pain sensitivity and postoperative acute pain severity is mediated by them. Therefore, intervention programs aimed at boosting pain self-efficacy and reducing pain catastrophizing can enhance postoperative pain outcomes for abdominal surgery patients.
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Affiliation(s)
- Ling Wang
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Fang Qin
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; School of Nursing, Southern Medical University, Guangzhou, Guangdong, China.
| | - Hao Liu
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiao-Hua Lu
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Li Zhen
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - Guo-Xin Li
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
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Ren Y, Guo Y, Tang J, He L, Li M, Huang X, Lu Q, Sun B, Feng H, Liu H, Du J, Li J. Effect of Personality and Pain Catastrophizing on Postoperative Analgesia Following Cesarean Section: A Prospective Cohort Study. J Pain Res 2024; 17:11-19. [PMID: 38192365 PMCID: PMC10771724 DOI: 10.2147/jpr.s443230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/28/2023] [Indexed: 01/10/2024] Open
Abstract
Purpose This study aimed to investigate the effects of different psychological personalities and pain catastrophizing levels on postoperative analgesia in patients undergoing cesarean section. Patients and Methods Puerperas who underwent cesarean section at our hospital between January and August 2023 were recruited into the study and assessed using the Eysenck Personality Questionnaire-Revised Short Scale (EPQRSC) and Pain Catastrophizing Scale (PCS). Data on the numerical pain intensity at rest and during activity 24 h after surgery, number and dosage of analgesia pumps, and satisfaction with analgesia were recorded. According to the numerical pain score during activity 24 h post-operation, the patients were divided into the analgesia incomplete group (≥4) and control group (<4). Univariate analysis, Spearman correlation analysis, and binary logistic regression analysis were used to evaluate the influence of personality characteristics and PCS on postoperative analgesia. Results A total of 778 women were included in the study. The incidence of inadequate analgesia was 89.8%. The satisfaction rate of analgesia was 66.8%. Univariate analysis showed that extraversion; neuroticism; PCS; numbers of previous cesarean delivery; ASA; analgesic satisfaction; and 24-h analgesia pump compressions and dosage were associated with postoperative analgesia after cesarean section (P<0.05). Using binary logistic regression analysis, the first cesarean section (odds ratio [OR]=0.056, 95% confidence interval [CI]=1.913-19.174), the number of 24-h analgesic pump compressions (OR=8.464, 95% CI=0.356-0.604), extraversion (OR=0.667, 95% CI=0.513-0.866), neuroticism (OR=1.427, 95% CI=1.104-1.844), and PCS (OR=7.718, 95% CI=0.657-0.783) were factors affecting postoperative analgesia. Conclusion The incidence of inadequate analgesia after a cesarean section was high (89.8% on the first day after surgery). Formulating accurate analgesia programs for women undergoing cesarean section with extraversion, neuroticism personality characteristics, and pain catastrophizing behaviors is necessary for improving their postoperative analgesia effects and satisfaction and promoting postpartum comfort.
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Affiliation(s)
- Yunhong Ren
- Mianyang Key Laboratory of Anesthesia and Neuroregulation, Department of Anesthesiology, Mianyang Central Hospital, Mianyang, Sichuan, 621000, People’s Republic of China
| | - Yinhao Guo
- Department of Anesthesiology, North Sichuan Medical College, Nanchong, Sichuan, 637000, People’s Republic of China
| | - Jing Tang
- Department of Anesthesiology, North Sichuan Medical College, Nanchong, Sichuan, 637000, People’s Republic of China
| | - Ling He
- Mianyang Key Laboratory of Anesthesia and Neuroregulation, Department of Anesthesiology, Mianyang Central Hospital, Mianyang, Sichuan, 621000, People’s Republic of China
| | - Meiling Li
- Mianyang Key Laboratory of Anesthesia and Neuroregulation, Department of Anesthesiology, Mianyang Central Hospital, Mianyang, Sichuan, 621000, People’s Republic of China
| | - Xuemei Huang
- Mianyang Key Laboratory of Anesthesia and Neuroregulation, Department of Anesthesiology, Mianyang Central Hospital, Mianyang, Sichuan, 621000, People’s Republic of China
| | - Qin Lu
- Mianyang Key Laboratory of Anesthesia and Neuroregulation, Department of Anesthesiology, Mianyang Central Hospital, Mianyang, Sichuan, 621000, People’s Republic of China
| | - Baoxia Sun
- Mianyang Key Laboratory of Anesthesia and Neuroregulation, Department of Anesthesiology, Mianyang Central Hospital, Mianyang, Sichuan, 621000, People’s Republic of China
| | - Haixia Feng
- Mianyang Key Laboratory of Anesthesia and Neuroregulation, Department of Anesthesiology, Mianyang Central Hospital, Mianyang, Sichuan, 621000, People’s Republic of China
| | - Huan Liu
- Mianyang Key Laboratory of Anesthesia and Neuroregulation, Department of Anesthesiology, Mianyang Central Hospital, Mianyang, Sichuan, 621000, People’s Republic of China
| | - Juan Du
- Mianyang Key Laboratory of Anesthesia and Neuroregulation, Department of Anesthesiology, Mianyang Central Hospital, Mianyang, Sichuan, 621000, People’s Republic of China
| | - Jun Li
- Mianyang Key Laboratory of Anesthesia and Neuroregulation, Department of Anesthesiology, Mianyang Central Hospital, Mianyang, Sichuan, 621000, People’s Republic of China
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Albzea W, Almonayea L, Aljassar M, Atmeh M, Al Sadder K, AlQattan Y, Alhajaji R, AlNadwi H, Alnami I, Alhajaji F. Efficacy and Safety of Preoperative Melatonin for Women Undergoing Cesarean Section: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1065. [PMID: 37374268 DOI: 10.3390/medicina59061065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/26/2023] [Accepted: 05/27/2023] [Indexed: 06/29/2023]
Abstract
Background: Cesarean section (CS) has been linked to a number of negative effects, such as pain, anxiety, and sleeping problems. The aim of this systematic review and meta-analysis was to investigate the safety and efficacy of preoperative melatonin on postoperative outcomes in pregnant women who were scheduled for elective CS. Methods: We systemically searched 4 electronic databases (PubMed, Scopus, Web of Science, and Cochrane Library) from inception until 10 March 2023. We included randomized controlled trials (RCTs) comparing melatonin and placebo for postoperative outcomes in CS patients. For risk of bias assessment, we used the Cochrane Risk of Bias 2 tool. Continuous variables were pooled as mean difference (MD), and categorical variables were pooled as a risk ratio (RR) with a 95% confidence interval (CI). Results: We included 7 studies with a total of 754 pregnant women scheduled for CS. The melatonin group had a lower pain score (MD = -1.23, 95% CI [-1.94, -0.51], p < 0.001) and longer time to first analgesic request (MD = 60.41 min, 95% CI [45.47, 75.36], p < 0.001) than the placebo group. No difference was found regarding hemoglobin levels, heart rate, mean arterial pressure, total blood loss, or adverse events. Conclusions: Preoperative melatonin may reduce postoperative pain in CS patients without side effects. This research offers a safe and affordable pain management method for this population, which has clinical consequences. Further research is needed to validate these findings and determine the best melatonin dosage and timing.
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Affiliation(s)
- Wardah Albzea
- Faculty of Medicine, Alexandria University, Alexandria 21544, Egypt
| | - Lolwa Almonayea
- Kuwait Institute for Medical Specializations, Kuwait City 12050, Kuwait
| | - Marah Aljassar
- Kuwait Institute for Medical Specializations, Kuwait City 12050, Kuwait
| | - Mousa Atmeh
- Department of Hemto-Oncology, Royal Medical Services, Amman 11855, Jordan
| | - Khaled Al Sadder
- Department of General Surgery, Ministry of Health, Kuwait City 12009, Kuwait
| | - Yousef AlQattan
- Kuwait Institute for Medical Specializations, Kuwait City 12050, Kuwait
| | - Raghad Alhajaji
- Department of Family Medicine, Almagrah Primary Health Care, Ministry of Health, Makkah 11176, Saudi Arabia
| | - Hiba AlNadwi
- King Abdullah Medical City, Makkah 57657, Saudi Arabia
| | - Inaam Alnami
- Senior Registerar Family Medicine, Internal Medicine Department, Security Forces Hospital Program, Makkah 14799, Saudi Arabia
| | - Fatima Alhajaji
- College of Medicine, Umm Alqura University, Makkah 57483, Saudi Arabia
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Arsyi DH, Permana PBD, Karim RI, Abdurachman. The role of optimism in manifesting recovery outcomes after coronary artery bypass graft surgery: A systematic review. J Psychosom Res 2022; 162:111044. [PMID: 36170801 DOI: 10.1016/j.jpsychores.2022.111044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Coronary artery bypass graft (CABG) is a major surgery conducted in coronary heart disease management. Postoperative recovery is a crucial process for patients undergoing CABG. This systematic review evaluates current evidence regarding the association between trait optimism and recovery outcomes in patients following coronary artery bypass graft surgery. METHODS This review followed the Preferred Reporting Items of Systematic Review and Meta-Analysis (PRISMA) 2020 Guideline. The inclusion criteria focused on observational study that examined study participants aged ≥18 years old undergoing elective CABG and measurement of trait optimism with validated methods (i.e. LOT, LOT-R) and at least one recovery outcome. Studies in non-English languages and duplicates were excluded. A systematic literature search was carried out on PubMed, Scopus, and Web of Science electronic databases. Search results were screened based on the eligibility criteria. The Newcastle-Ottawa Scale was used to assess the quality of each included study. RESULTS The search yielded a total of 1853 articles, in which 7 articles fulfilled the eligibility criteria and were subsequently included in the analysis. Measurement of trait optimism was conducted on 1276 patients who underwent a non-emergency/elective CABG. Optimism was significantly associated with several categories of recovery, including reduced rehospitalization rate, complications, pain, and physical symptoms along with improved quality of life, rate of return to normal life, and psychological status. CONCLUSION Our review showed that trait optimism was associated with recovery outcomes following CABG surgery. However, the heterogeneity of recovery outcomes may hamper the clinical benefit of trait optimism in CABG. (PROSPERO CRD42022301882).
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Affiliation(s)
- Danial Habri Arsyi
- Faculty of Medicine, Universitas Airlangga, Mayjend. Prof. Dr. Moestopo Street no. 47, Surabaya, East Java 60132, Indonesia.
| | - Putu Bagus Dharma Permana
- Faculty of Medicine, Universitas Airlangga, Mayjend. Prof. Dr. Moestopo Street no. 47, Surabaya, East Java 60132, Indonesia.
| | - Raden Ikhsanuddin Karim
- Faculty of Medicine, Universitas Airlangga, Mayjend. Prof. Dr. Moestopo Street no. 47, Surabaya, East Java 60132, Indonesia.
| | - Abdurachman
- Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Mayjend. Prof. Dr. Moestopo Street no. 47, Surabaya, East Java 60132, Indonesia.
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The influence of preoperative anxiety on postoperative pain in patients undergoing cardiac surgery. Sci Rep 2022; 12:16464. [PMID: 36183003 PMCID: PMC9526739 DOI: 10.1038/s41598-022-20870-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
Patients undergoing cardiac surgery represent a challenge in terms of pain management due to multiple factors relating to the patients and to the procedure itself. Our aim was to identify the influence of levels of preoperative anxiety on postoperative pain in patients undergoing cardiac surgery and explore associations between preoperative anxiety, postoperative pain, analgesic requirements, and sex. We present a prospective cohort study of 116 patients undergoing cardiac surgery between January and April 2020. Preoperative anxiety was evaluated using the State-Trait Anxiety Inventory and the amount of morphine needed to keep pain intensity below 4 on the verbal numerical rating scale was recorded for 48 h post-surgery. Given the extracorporeal circulation time, type of surgery and body surface, it was observed that every percentile increase in preoperative state anxiety led to an extra 0.068 mg of morphine being administered. For each extra year of age, the amount of morphine needed decreased by 0.26 mg, no difference was observed between men and women in terms of preoperative anxiety or postoperative analgesics requirements. It may be concluded that in cardiac surgery, postoperative analgesic requirements increased with higher levels of preoperative state anxiety and decreased for every extra year of age.
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