Journal
JOURNAL OF PAIN
Volume 13, Issue 11, Pages 1045-1057Publisher
CHURCHILL LIVINGSTONE
DOI: 10.1016/j.jpain.2012.07.014
Keywords
Hysterectomy; persistent postsurgical pain; anxiety; emotional illness representation; pain catastrophizing
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Funding
- Portuguese Foundation of Science and Technology [SFRH/BD/36368/2007]
- Fundação para a Ciência e a Tecnologia [PTDC/SAU-NEU/108557/2008, SFRH/BD/36368/2007] Funding Source: FCT
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Persistent postsurgical pain (PPSP) is a major clinical problem with significant individual, social, and healthcare costs. The aim of this study was to examine the role of demographic, clinical, and psychological risk factors in the development of PPSP after hysterectomy due to benign disorders. In a prospective study, a consecutive sample of 186 women was assessed 24 hours before surgery (T1), 48 hours after surgery (T2), and 4 months after surgery (13). Regression analyses were performed to identify predictors of PPSP. Four months after hysterectomy, 93 (50%) participants reported experiencing pain (numerical rating scale >0). Age, pain due to other causes, and type of hysterectomy emerged as significant predictive factors. Baseline presurgical psychological predictors identified were anxiety, emotional illness representation of the condition leading to surgery, and pain catastrophizing. Among the identified psychological predictors, emotional illness representation emerged as the strongest. Acute postsurgical pain frequency and postsurgical anxiety also revealed a predictive role in PPSP development. These results increase the knowledge on PPSP predictors and point healthcare professionals toward specific intervention targets such as anxiety (presurgical and postsurgical), pain catastrophizing, emotional illness representations, and acute pain control after surgery. Perspective: This study found that presurgical anxiety, emotional illness representations, and pain catastrophizing are risk factors for PPSP 4 months after hysterectomy, over and above age and clinical variables. These findings improve knowledge on PPSP and highlight potential intervention targets for healthcare professionals. (C) 2012 by the American Pain Society
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