Psychological factors and surgical recovery

Munafo, Marcus Robert (1999) Psychological factors and surgical recovery. University of Southampton, Doctoral Thesis.

Abstract

Understanding the factors that are related to surgical recovery would be of clear theoretical and potential clinical value. Although a substantial body of research exists that attempts to further this understanding across a range of surgical procedures, little consensus exists within this literature regarding the exact nature of predictive factors or, indeed, which factors are predictive. This thesis presents data from three studies that attempt to resolve some of the confusion in this area.

Specifically, the underlying assumption of the research conducted is that the measurement of psychological factors that are of potential value in predicting and understanding surgical recovery is frequently limited in such research by an over-reliance on highly uniform methodologies and methods of measurement. A novel approach is reported that characteristics emotional state as being related to changes in a number of overlapping but distinct systems (e.g. physiological vs cognitive). The objective of this thesis is to demonstrate the value of investigating surgical recovery with a clear understanding of the particular system under investigation and the outcome variable to which it conceptually might be expected to be related.

Results are presented from two studies that attempted to incorporate a cognitive index (the emotional Stroop task) of psychological state (specifically, anxiety) as a novel predictor of surgical recovery. Difficulties were encountered in replicating the widely reported emotional Stroop effect. The predictive power of measures of emotional state was equivocal across studies, although some consistent predictors (age and trait anxiety) of surgical recovery did emerge.

It is suggested that the conceptual approach to investigating surgical recovery adopted may yet prove valuable in clarifying the complex relationships between psychological and physical variables in surgical patients. Nevertheless, the modest effect sizes of the demonstrated relationships suggest that such research is likely to be of limited clinical application in the near future.

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