Patient experiences of anxiety, depression and acute pain after surgery: a longitudinal perspective

• Published in: International journal of nursing studies 2005-07, Vol.42 (5), p.521-530
• Main Authors: Carr, Eloise C.J., Nicky Thomas, Veronica, Wilson-Barnet, Jenifer
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Aged; Aged, 80 and over; Analysis; Analysis of Variance; Anxiety; Anxiety - diagnosis; Anxiety - etiology; Anxiety - psychology; Attitude to Health; Depression; Depression - diagnosis; Depression - etiology; Depression - psychology; Depression, Mental; Educational Status; Female; Gynecologic Surgical Procedures - adverse effects; Gynecologic Surgical Procedures - nursing; Gynecologic Surgical Procedures - psychology; Health Services Needs and Demand; Humans; Impact analysis; Longitudinal Studies; Middle Aged; Nursing; Nursing Methodology Research; Pain Measurement; Pain, Postoperative; Pain, Postoperative - diagnosis; Pain, Postoperative - etiology; Pain, Postoperative - psychology; Post-operative pain; Postoperative pain; Predictive Value of Tests; Psychiatric Status Rating Scales; Psychological aspects; Regression Analysis; Risk Factors; Severity of Illness Index; Social Support; Surveys and Questionnaires; Women; Women - education; Women - psychology
• ISSN: 0020-7489; 1873-491X
• DOI: 10.1016/j.ijnurstu.2004.09.014

This study sought to explore the impact of the psychological variables anxiety and depression, on pain experience over time following surgery. Eighty-five women having major gynaecological surgery were assessed for anxiety, depression and pain after surgery. To gain further understanding, 37 patients participated in a semi-structured taped telephone interview 4–6 weeks post-operatively. Pre-operative anxiety was found to be predictive of post-operative anxiety on Day 2, with patients who experienced high levels of anxiety before surgery continuing to feel anxious afterwards. By Day 4 both anxiety and depression scores increased as pain increased and one-third of the sample experienced levels of anxiety in psychiatric proportions whilst under one-third experienced similar levels of depression. These findings have significant implications for the provision of acute pain management after surgery. Future research and those managing acute pain services need to consider the multidimensional effect of acute pain and the interface between primary and secondary care.