Department of Anesthesia and Operative Services, Kuopio University Hospital (KYS), Puijonlaaksontie 2, PO Box 100, 70029, Kuopio, Finland.
School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
BMC Womens Health. 2022 Aug 16;22(1):345. doi: 10.1186/s12905-022-01923-7.
Gynecological surgery has many impacts on women's physical and mental health, and efforts to improve recovery from surgery are constantly under evaluation. Resilience is an ability to overcome stressors and adversities, such as traumas and surgeries. This study aimed to explore patients' resilience and psychological symptoms in relation to recovery, health-related quality of life (HRQoL), and pain one year after gynecological surgery.
In a prospective cohort study, we enrolled consecutive elective gynecologic surgery patients who completed questionnaires before and at one year after surgery: the Resilience Scale-25, the 15D instrument of HRQoL (15D), the Life Satisfaction Scale-4, and the Hospital Anxiety and Depression Scale. Their mean 15D scores were compared to those of an age-matched sample of women from the general Finnish population (n = 2743).
We enrolled 271 women who underwent gynecological surgery due to benign (n = 190) and malignant (n = 81) diagnoses. Resilience was equally high in women with benign and malignant diagnoses at both time points. Higher resilience associated with less pain, analgesic use, and better pain relief from the use of pain medication at 12 months after surgery. Pain intensity was similar in the two groups, but patients with benign diseases had less pain at 12 months than before surgery. Before surgery, patients' HRQoL was worse than that of the general population, but at 12 months the mean HRQoL of patients with benign diseases had improved to the same level as that in the general population but had decreased further in patients with malignant diseases. Anxiety was higher and life satisfaction was lower in patients with malignant diseases before surgery. At 12 months, anxiety had decreased in both groups, and life satisfaction had increased in patients with malignant diseases. Depression was similarly low in both groups and time points.
Resilience correlated with less pain one year after surgery. After surgery, HRQoL improved in patients with benign diseases but deteriorated in patients with malignant diseases. Patients with low resilience should be identified during preoperative evaluation, and health care professionals should give these patients psychological support to enhance their resilience. Trial Registration ClinicalTrials.gov; registered October 29, 2019; identifier: NCT04142203; retrospectively registered.
妇科手术对女性身心健康有诸多影响，不断有努力旨在改善手术康复效果。韧性是一种克服压力和逆境的能力，例如创伤和手术。本研究旨在探讨妇科手术后患者的韧性和心理症状与康复、健康相关生活质量（HRQoL）和疼痛之间的关系，研究对象为术后 1 年的患者。
本前瞻性队列研究纳入了接受择期妇科手术的连续患者，在手术前后完成了问卷：25 项韧性量表（Resilience Scale-25）、15D 健康相关生活质量量表（15D）、生活满意度量表-4（Life Satisfaction Scale-4）和医院焦虑抑郁量表（Hospital Anxiety and Depression Scale）。将他们的平均 15D 评分与来自一般芬兰人群的年龄匹配样本（n=2743）进行比较。
共纳入 271 名因良性（n=190）和恶性（n=81）诊断而接受妇科手术的女性。在两个时间点，良性和恶性诊断的女性的韧性水平相当。更高的韧性与术后 12 个月时更少的疼痛、更少的镇痛药物使用和更好的疼痛缓解相关。两组的疼痛强度相似，但良性疾病患者术后 12 个月的疼痛程度低于术前。手术前，患者的 HRQoL 差于一般人群，但术后 12 个月，良性疾病患者的 HRQoL 已改善至与一般人群相同水平，但恶性疾病患者的 HRQoL 进一步下降。手术前，恶性疾病患者的焦虑水平更高，生活满意度更低。术后 12 个月，两组的焦虑水平均有所下降，恶性疾病患者的生活满意度有所提高。两组和两个时间点的抑郁水平相似。
术后 1 年时，韧性与疼痛程度相关。良性疾病患者术后 HRQoL 改善，但恶性疾病患者 HRQoL 恶化。在术前评估中应识别出低韧性患者，医护人员应为这些患者提供心理支持，以增强其韧性。
ClinicalTrials.gov；注册于 2019 年 10 月 29 日；标识符：NCT04142203；回顾性注册。
