Powell, Rachael, Johnston, Marie, Smith, W. Cairns, King, Peter M., Chambers, W. Alastair, McKee, Lorna and Bruce, J. (Julie) (2013) Rehabilitation following surgery : clinical and psychological predictors of activity limitations. Rehabilitation Psychology, 58 (4). pp. 350-360. doi:10.1037/a0034660

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Abstract

Purpose/Objective: Activity limitations following surgery are common, and patients may have an extended period of pain and rehabilitation. Inguinal hernia surgery is a common elective procedure. This study incorporated fear-avoidance models in investigating cognitive and emotional variables as potential risk factors for activity limitations 4 months after inguinal hernia surgery. Method: This was a prospective cohort study, predicting activity limitations 4 months postoperatively (Time 3 [T3]) from measures taken before surgery (Time 1, [T1]) and 1 week after surgery (Time 2 [T2]). The sample size at T1 was 135; response rates were 89% and 84% at T2 and T3 respectively. Questionnaires included measures of catastrophizing, fear of movement, depression, anxiety, optimism, perceived control over pain, pain, and activity limitations. Biomedical and surgical variables were recorded. Predictors of T3 activity limitations from T1 and T2 were examined in hierarchical multiple regression equations. Results: Over half of participants (57.7%) reported activity limitations due to their hernia at 4 months post-surgery. Higher activity limitation levels were significantly predicted by older age, higher preoperative activity limitations, higher preoperative anxiety, and more severe postoperative pain and depression scores. Conclusions/Implications: Interventions to reduce preoperative anxiety and postoperative depression may lead to reduced 4-month activity limitations. However, the additional variance explained by psychological variables was low (ΔR² = 0.05). Our models, which included biomedical and surgical variables, accounted for less than 50% of the variance in activity limitations overall. Therefore, further investigation of psychological variables, particularly cognitions related specifically to activity behavior, would be merited. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Item Type:	Journal Item
Subjects:	R Medicine > R Medicine (General)
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School
Journal or Publication Title:	Rehabilitation Psychology
Publisher:	American Psychological Association
ISSN:	0090-5550
Official Date:	November 2013
Dates:	Date Event November 2013 Published
Volume:	58
Number:	4
Page Range:	pp. 350-360
DOI:	10.1037/a0034660
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access

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