Psychological prophylaxis training for coping with postoperative pain. Long-term effects

• Published in: Schmerz (Berlin, Germany) Germany), 2014-10, Vol.28 (5), p.513-519
• Main Authors: Scheel, J, Parthum, A, Dimova, V, Horn-Hofmann, C, Horn-Hoffmann, C, Meinfelder, F, Carbon, R, Grießinger, N, Sittl, R, Lautenbacher, S
• Format: Article
• Language: ger
• Subjects: Adaptation, Psychological; Adolescent; Adult; Anxiety - prevention & control; Anxiety - psychology; Arousal; Catastrophization - prevention & control; Catastrophization - psychology; Cognitive Therapy - methods; Combined Modality Therapy - methods; Combined Modality Therapy - psychology; Follow-Up Studies; Funnel Chest - psychology; Funnel Chest - surgery; Humans; Male; Pain Management - methods; Pain Measurement - psychology; Pain, Postoperative - prevention & control; Pain, Postoperative - psychology; Patient Education as Topic - methods; Relaxation Therapy; Young Adult
• ISSN: 1432-2129
• DOI: 10.1007/s00482-014-1476-5

The present study was performed to investigate the effect of multidimensional psychological prophylaxis training focusing on coping with cognitive-emotional pain on recovery within the first 12 months after surgery. The training included the following three components: (1) education about pain, analgesia and psychological aspects of coping with pain, (2) training for coping with pain and (3) body-centered relaxation. In the study 48 young male patients (surgical correction of a chest malformation) were assessed 1 day before surgery, at discharge and 3, 6 and 12 months postoperatively concerning postoperative pain intensity and pain disability as well as pain anxiety, pain catastrophizing and pain hypervigilance. Additionally, 24 of these patients received training on cognitive-emotional coping with pain 1 day before surgery and 1-3 days after surgery (each session 1 h). The proportion of patients with clinically relevant improvement was significantly higher in the training group compared to the control group. This was the case for acute pain intensity (approximately 1 week after surgery), pain disability 3 months later and pain anxiety 12 months after surgery. The resurgence of pain anxiety after 12 months could only be found in the control group and could be due to the upcoming surgical removal of the transsternal metal implant. The prophylaxis training can therefore be seen as a protective factor for long-term management of surgery-related consequences and future pain experiences.