Surgery, complications and quality of life: a longitudinal cohort study exploring the role of psychosocial factors

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Title: Surgery, complications and quality of life: a longitudinal cohort study exploring the role of psychosocial factors
Authors: Archer, SA
Pinto, A
Vuik, S
Bicknell, C
Faiz, O
Byrne, B
Johnston, M
Skapinakis, P
Athanasiou, T
Vincent, C
Darzi, A
Item Type: Journal Article
Abstract: Objective: To determine if psychosocial factors moderate the relationship between surgical complications and quality of life (QoL). Summary Background: Patients who experience surgical complications have significantly worse post-operative QoL than patients with an uncomplicated recovery. Psychosocial factors, such as coping style and level of social support influence how people deal with stressful events, but it is unclear if they impact on QoL following a surgical complication. These findings can inform the development of appropriate interventions that support patients post-operatively. Methods: This is a longitudinal cohort study; data were collected at pre-op, 1 month post-op, 4 months post-op and 12 months post-op. A total of 785 patients undergoing major elective gastro-intestinal, vascular or cardio-thoracic surgery were recruited from 28 National Health Service (NHS) sites in England and Scotland took part in the study. Results: Patients who experience major surgical complications report significantly reduced levels of physical and mental QoL (p<0.05) but they make a full recovery over time. Findings indicate that a range of psychosocial factors such as the use of humor as a coping style and the level of health care professional support may moderate the impact of surgical complications on QoL. Conclusion: Surgical complications alongside other socio-demographic and psychosocial factors contribute to changes in QoL; the results from this exploratory study suggest that interventions that increase the availability of healthcare professional support and promote more effective coping strategies prior to surgery may be useful, particularly in the earlier stages of recovery where QoL is most severely compromised. However, these relationships should be further explored in longitudinal studies that include other types of surgery and employ rigorous recruitment and follow up procedures.
Issue Date: Jul-2019
Date of Acceptance: 12-Mar-2018
ISSN: 0003-4932
Publisher: Lippincott, Williams & Wilkins
Start Page: 95
End Page: 101
Journal / Book Title: Annals of Surgery
Volume: 270
Issue: 1
Copyright Statement: © 2018 Wolters Kluwer Health, Inc. This is a non-final version of an article published in final form in Stephanie Archer, Anna Pinto, Sabine Vuik, Colin Bicknell, Omar Faiz, Ben Byrne, Maximilian Johnston, Petros Skapinakis, Thanos Athanasiou, Charles Vincent, Ara Darzi. Surgery, Complications, and Quality of Life: A Longitudinal Cohort Study Exploring the Role of Psychosocial Factors, Annals of Surgery. 270(1):95–101, JULY 2019. DOI: 10.1097/SLA.0000000000002745
Sponsor/Funder: Imperial College Healthcare NHS Trust
National Institute for Health Research (NIHR)
National Institute for Health Research
National Institute of Health Research
Funder's Grant Number: RDPSC 79560
RDPSC 79560
Keywords: Science & Technology
Life Sciences & Biomedicine
quality of life
surgical complications
11 Medical and Health Sciences
Publication Status: Published
Embargo Date: 2020-07-01
Appears in Collections:Division of Surgery
Faculty of Medicine

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