Factors Associated with Psychological Distress at Home following Elective Surgery in a Representative Group of Surgical Patients: An Explorative Panel Study

Abstract

Background. Physical care and the provision of harmless treatment is the main objective of peri-operative nursing care with psychological distress being less addressed. Aim. The aim of the study is to describe postoperative psychological distress of elective surgical patients and identify factors that are present or known during hospitalisation and detect their associations with the psychological distress at home at least four weeks post discharge from the hospital. Method. 390 patients participated in the study. Symptoms of psychological distress were measured with the Hospital Anxiety and Depression Scale. Results. Surgical patients experience symptoms of anxiety and depression, with spinal patients experiencing most symptoms. The symptom causing most patients (10%) the greatest distress prior to surgery was trouble with movement. Younger age, scores on the HADS subscales at the hospital, and pain and symptoms at the hospital, correlated sifnificantly with scores on the HADS subscales at home. Women, patients on a waiting list before the surgery, those who were not very satisfied with care received at the hospital, patients with children at home and those that had lung disease or a psychiatric disorder scored higher on the HADS subscales at home than their counterparts. Conclusion. Nurses should routinely screen patients for psychological distress at home and develop realistic intervention strategies.

Symptoms of anxiety and depression in surgical patients at the hospital, 6 weeks and 6 months postsurgery: A questionnaire study

“…as measured with HADS, both at hospital and up to 6 months postdischarge. In addition, our findings confirm earlier findings that having symptoms of anxiety or depression predicts symptoms of anxiety and depression (Sveinsdóttir, 2010;Sveinsdóttir & Ingadóttir, 2012;Sveinsdóttir & Skúladóttir, 2012), indicating that psychological care is of utmost importance.…”

“…Distress caused by postoperative symptoms was the strongest predictor of symptoms of anxiety six weeks postsurgery and symptoms of depression six weeks and 6 months postsurgery. In addition, similar to earlier findings (Sveinsdóttir, 2010; Sveinsdóttir & Ingadóttir, 2012; Sveinsdóttir & Skúladóttir, 2012), more symptoms of anxiety or depression at one time point predict more symptoms at the next time point. A study on depression screening after cardiac surgery found that patients meeting screening criteria for depression at the hospital presented with a higher risk of major adverse cardiac event, depressive mood and having started antidepressants 12 months postdischarge (Tully, Baumeister, Bennets, Rice, & Baker, 2016).…”

“…Studies on the influence of pre-operative anxiety and depression symptoms on outcomes have found these disturbances to be associated with more severe physical symptoms, hospital readmissions, longer hospital stay, increased cardiac events, worse general function, pain, lower quality of life and various postoperative complications (Blumenthal et al, 2003;Faller, Kirschner, & Konig, 2003;Geulayov et al, 2018;Gold et al, 2016;Hanusch, O'Connor, Ions, Scott, & Gregg, 2014;Kagan & Bar-Tal, 2008;Poole et al, 2014Poole et al, , 2017Rasouli, Menendez, Sayadipour, Purtill, & Parvizi, 2016;Rolfson, Dahlberg, Nilsson, Malchau, & Garellick, 2009;Stark et al, 2016;Tully et al, 2014Tully et al, , 2015. The presence of symptoms of anxiety or depression at the time of surgery, along with pain and not feeling rested upon awakening, seems to be a major contributor to the presence of those same symptoms postsurgery (Basak et al, 2015;Sveinsdóttir, 2010).…”

Validation of the Brazilian Version of the Screening Tool for Psychosocial Distress (Stop-D) for Cardiac Patients

“…Increased levels of distress-related hormones can affect the cardiovascular system and worsen the prognosis of the patients. 10 In addition, distress has been associated with fatigue level, 11 increased risk of rehospitalization, 12 higher mortality rate, 7,13,14 and poor cardiac prognosis. 15,16 Thus, distress can potentiate the complications of heart disease.…”