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Risk Factors for Persistent Postsurgical Pain in Women Undergoing Hysterectomy Due to Benign Causes: A Prospective Predictive Study

  • Patrícia R. Pinto
    Affiliations
    Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal

    ICVS / 3B's – PT Government Associate Laboratory, Braga/Guimarães, Portugal

    Institute of Health & Society, Health Psychology Group, Newcastle University, Newcastle, United Kingdom
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  • Teresa McIntyre
    Affiliations
    Texas Institute for Measurement, Evaluation and Statistics (TIMES) and Department of Psychology, University of Houston, Houston, Texas
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  • Cristina Nogueira-Silva
    Affiliations
    Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal

    ICVS / 3B's – PT Government Associate Laboratory, Braga/Guimarães, Portugal

    Department of Obstetrics and Gynecology, Hospital de Braga, Braga, Portugal
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  • Armando Almeida
    Affiliations
    Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal

    ICVS / 3B's – PT Government Associate Laboratory, Braga/Guimarães, Portugal
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  • Vera Araújo-Soares
    Correspondence
    Address reprint requests to Vera Araújo-Soares, PhD, Senior Lecturer in Health Psychology, Institute of Health & Society, Faculty of Medical Sciences, Newcastle University, Baddiley-Clark Building, Richardson Road, NE2 4AX, Newcastle, UK.
    Affiliations
    Institute of Health & Society, Health Psychology Group, Newcastle University, Newcastle, United Kingdom

    Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
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Published:October 15, 2012DOI:https://doi.org/10.1016/j.jpain.2012.07.014

      Abstract

      Persistent postsurgical pain (PPSP) is a major clinical problem with significant individual, social, and healthcare costs. The aim of this study was to examine the role of demographic, clinical, and psychological risk factors in the development of PPSP after hysterectomy due to benign disorders. In a prospective study, a consecutive sample of 186 women was assessed 24 hours before surgery (T1), 48 hours after surgery (T2), and 4 months after surgery (T3). Regression analyses were performed to identify predictors of PPSP. Four months after hysterectomy, 93 (50%) participants reported experiencing pain (numerical rating scale >0). Age, pain due to other causes, and type of hysterectomy emerged as significant predictive factors. Baseline presurgical psychological predictors identified were anxiety, emotional illness representation of the condition leading to surgery, and pain catastrophizing. Among the identified psychological predictors, emotional illness representation emerged as the strongest. Acute postsurgical pain frequency and postsurgical anxiety also revealed a predictive role in PPSP development. These results increase the knowledge on PPSP predictors and point healthcare professionals toward specific intervention targets such as anxiety (presurgical and postsurgical), pain catastrophizing, emotional illness representations, and acute pain control after surgery.

      Perspective

      This study found that presurgical anxiety, emotional illness representations, and pain catastrophizing are risk factors for PPSP 4 months after hysterectomy, over and above age and clinical variables. These findings improve knowledge on PPSP and highlight potential intervention targets for healthcare professionals.

      Key words

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