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Psychological risk factors for chronic post‐surgical pain after inguinal hernia repair surgery: A prospective cohort study
Author(s) -
Powell R.,
Johnston M.,
Smith W.C.,
King P.M.,
Chambers W.A.,
Krukowski Z.,
McKee L.,
Bruce J.
Publication year - 2012
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1016/j.ejpain.2011.08.010
Subject(s) - medicine , inguinal hernia , inguinal hernia surgery , anxiety , prospective cohort study , chronic pain , pain catastrophizing , physical therapy , worry , surgery , depression (economics) , hernia , psychiatry , macroeconomics , economics
A significant proportion of patients experience chronic post‐surgical pain ( CPSP ) following inguinal hernia surgery. Psychological models are useful in predicting acute pain after surgery, and in predicting the transition from acute to chronic pain in non‐surgical contexts. This is a prospective cohort study to investigate psychological (cognitive and emotional) risk factors for CPSP after inguinal hernia surgery. Participants were asked to complete questionnaires before surgery and 1 week and 4 months after surgery. Data collected before surgery and 1 week after surgery were used to predict pain at 4 months. Psychological risk factors assessed included anxiety, depression, fear‐avoidance, activity avoidance, catastrophizing, worry about the operation, activity expectations, perceived pain control and optimism. The study included 135 participants; follow‐up questionnaires were returned by 119 (88.1%) and 115 (85.2%) participants at 1 week and 4 months after surgery respectively. The incidence of CPSP (pain at 4 months) was 39.5%. After controlling for age, body mass index and surgical variables (e.g. anaesthetic, type of surgery and mesh type used), lower pre‐operative optimism was an independent risk factor for CPSP at 4 months; lower pre‐operative optimism and lower perceived control over pain at 1 week after surgery predicted higher pain intensity at 4 months. No emotional variables were independently predictive of CPSP . Further research should target these cognitive variables in pre‐operative psychological preparation for surgery.