Personality Rather Than Clinical Variables Determines Quality of Life After Major Colorectal Surgery

PURPOSE: Clinical factors, especially the presence of a stoma, have been presumed to be the major determinants of quality of life after colorectal surgery. We investigated the relative influence of other variables, e. g., patient's personality, sense of coherence, and coping strategies, to determine the validity of this long-held assumption. METHODS: We investigated 79 patients undergoing major colorectal surgery. Quality of Life was assessed with the Short Form-36 and Gastrointestinal Quality of Life Index questionnaires at three and 12 months postsurgery. Additionally, baseline psychologic data on personality and sense of coherence were assessed. The results were analyzed in both a bivariate manner and by multivariate hierarchical regression analysis. RESULTS: In the bivariate analysis, clinical parameters had a small and temporary effect on quality of life, if any. In the multivariate model the character of the underlying disease and the presence of a stoma did not affect quality of life significantly. In contrast, emotional lability, extraversion, and sense of coherence had a strong and lasting influence, accounting for 49 percent of variance (Delta R-2) for emotional quality of life, 22 percent for physical and 32 percent for disease-specific Quality of Life. CONCLUSION: Personality exerts a strong and lasting effect on quality of life after colorectal surgery. This effect by far exceeds the influence of common clinical variables.