PREDICTORS OF POSTSURGICAL STRESS AMONG CARDIAC PATIENTS

Authors

  • Lavinia Maria PRUTEANU Universitatea „Petre Andrei” din Iasi

Keywords:

CARDIAC PATIENTS, STRESS VULNERABILITY, DISPOSITIONAL OPTIMISM, FEAR OF SURGERY, NEGATIVE AFFECTIVE DISPOSITION, POSTSURGICAL STRESS

Abstract

Aim: To explore the role of stress vulnerability, dispositional optimism, fears of surgery and negative affective disposition in prediction of postsurgical stress among cardiac patients who underwent heart surgery. Material and methods: The sample included 60 cardiac patients (39 males and 21 females, aged 58.50±10.97 years). All patients completed two sets of standardized questionnaires. Before surgical intervention, stress vulnerability, dispositional optimism and negative affective disposition were measured with N6-Scale (from NEO Personality Inventory–Revised Form), Life Orientation Test-Revised Form and Mental Health Index-5, respectively. Fear of surgery among patients was measured with an 8-item questionnaire designed for the current study. After intervention, patients completed a short postsurgical data form along with the Perceived Stress Scale. Results: There was no significant difference in postsurgical stress between the female and male cardiac patients (t = 0.96; p = 0.34). A similar result was obtained when the presence/absence of postsurgical complications was considered as an independent variable (t = 1.30; p = 0.19). As expected, a higher level of postsurgical stress was associated with higher stress vulnerability, surgery-related fear, negative affective disposition, and with a lower dispositional optimism score. Moreover, stress vulnerability and negative affective disposition were significant predictors of postsurgical stress. Conclusions: Cardiac patients who are prone to stress and negative affective disposition are also at higher risk for postsurgical stress. On its turn, this psychological condition interferes with time and quality of postsurgical recovery. A careful assessment of psychological condition along with counseling before surgical intervention is needed in order to reduce the risk of postsurgical stress and improve medical recovery in cardiac patients.

References

1. Vingerhoets G. Perioperative anxiety and depression in open-heart surgery. Psychosomatics 1998; 39: 30-37.
2. O’Hara M, Ghoneim MM, Hinrichs JV, Mehta MP, Wright EJ. Psychological consequences of sur-gery. 1989; 51: 356-370.
3. Contrada RJ, Boulifard DA, Hekler EB et al. Psychological factors in heart surgery: presurgical vul-nerability and postsurgical recovery. 2008; 27: 309-319.
4. Reivich K, Gillham J. Learned optimism: the measurement of explanatory style. In SJ Lopez, CR Snyder (editors). Positive Psychological Assessment: A Handbook of Models and Measures. Wash-ington, D.C.: American Psychological Association, 2003, 57-74.
5. Al AL, Seymour EM, Kronfol Z, Bolling SF. Mood states, coping factors, and interleukin-6 are related to psychiatric symptoms following cardiac surgery. Biol Psychiatry and Psychopharm 2011; 13: 3-9.
6. Conversano C, Rotondo A, Lensi E, Vista OD, Arpone F, Reda MA. Optimism and its impact on mental and psysical well-being. Clin Pract Epidemiol Ment Health 2010; 6: 25-29.
7. Fitzgerald TE, Tennen H, Affleck G, Pransky GS. The relative importance of dispositional optimism and control appraisals in quality of life after coronary artery bypass surgery. J Behav Med 1993; 16: 25-43.
8. Scheier MF, Matthews KA, Owens J et al. Optimism and rehospitalization after coronary artery bypass graft surgery. Arch Intern Med 1999; 159: 829-835.
9. Costa PT Jr, McCrae RR. Revised NEO Personality Inventory (NEO PI-R TM) and NEO Five-Factor Inventory (NEO-FFI). Professional Manual. Odessa, FL: Psychological Assessment Resources, Inc., 1992.
10. Matthews G, Deary IJ, Whiteman MC. Personality Traits (translated into Romanian). Iaşi: Polirom, 2005.
11. Carver CS, Scheier M. Optimism. In SJ Lopez, CR Snyder (editors). Positive Psychological Assess-ment: A Handbook of Models and Measures. Washington, D.C.: American Psychological Association, 2003, 75-89.
12. Scheier MF, Carver CS, Bridges MW. Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem). A reevaluation of the Life Orientation Test. J Pers Soc Psychol 1994; 67: 1063-1078.
13. Berwick DM, Murphy JM, Goldman PA, Ware JE Jr, Barsky AJ, Weinstein MC. Performance of a five-item mental health screening test. Med Care 1991; 29: 169-176.
14. Leung DYP, Lam TH, Chan SSC. Three versions of Perceived Stress Scale: validation in a sample of Chinese cardiac patients who smoke. BMC Public Health 2010; 10, 513. doi:10.1186/1471-2458-10-513.
15. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983; 24: 385-396.
16. Brant CS, Volk H, Kutner B. Psychological preparation for surgery. Public Health Rep 1958; 73: 1001-1007.
17. Duits AA, Duivenvoorden HJ, Boeke S et al. A structural modeling analysis of anxiety and depression in patients undergoing coronary artery bypass graft surgery: a model generating approach. J Psychosom Res, 1999; 46: 187-200.
18. Goyal TM, Idler EL, Krause TJ, Contrada RJ. Quality of life following cardiac surgery: impact of the severity and course of depressive symptoms. Psychosom Med 2005; 67: 759-765.
19. Pirraglia PA, Peterson JC, Williams-Russo P, Gorkin L, Charlson ME. Depressive symptomatology in coronary artery bypass surgery patients. Int J Geriatr Psychiatry 1999; 14: 668-680.
20. Johnston M, Vogele C. Benefits of psychological preparation for surgery: a meta-analysis. Ann Behav Med 1993; 15: 245-256.

Additional Files

Published

2018-05-09

Issue

Section

PREVENTIVE MEDICINE - LABORATORY