Rosenberger Patricia H, Jokl Peter, Ickovics Jeannette
Department of Epidemiology and Public Health, Yale University, School of Medicine, New Haven, CT 06520-80701, USA.
J Am Acad Orthop Surg. 2006 Jul;14(7):397-405. doi: 10.5435/00124635-200607000-00002.
The influence of psychosocial factors on clinical outcomes after surgery has been investigated in several studies. This review is limited to surgical outcomes studies published between 1990 and 2004 that include (1) psychosocial variables (eg, depression, social support) as predictors of outcome and that focus on (2) clinical outcomes (eg, postoperative pain, functional recovery) using (3) specific multivariate analytic techniques with (4) relevant clinical variables (eg, presurgical health status) included as covariates. Twenty-nine studies met these criteria. Results indicate that psychosocial factors play a significant role in recovery and are predictive of surgical outcome, even after accounting for known clinical factors. Attitudinal and mood factors were strongly predictive; personality factors were least predictive. The results suggest that preoperative consideration of attitudinal and mood factors will assist the surgeon in estimating both the speed and extent of postoperative recovery.
多项研究探讨了社会心理因素对手术后临床结局的影响。本综述仅限于1990年至2004年间发表的外科手术结局研究，这些研究包括：（1）将社会心理变量（如抑郁、社会支持）作为结局的预测因素；（2）关注临床结局（如术后疼痛、功能恢复）；（3）使用特定的多变量分析技术；（4）将相关临床变量（如术前健康状况）作为协变量纳入分析。共有29项研究符合这些标准。结果表明，即使在考虑了已知临床因素之后，社会心理因素在恢复过程中仍发挥着重要作用，并且可以预测手术结局。态度和情绪因素的预测性很强；人格因素的预测性最弱。结果表明，术前考虑态度和情绪因素将有助于外科医生评估术后恢复的速度和程度。
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