A new study led by surgeons at UCLA Health has found that psychological prehabilitation can significantly improve recovery after surgery. The research, spearheaded by Anne E. Hall in the lab of Dr. Justine Lee, analyzed data from 20 randomized controlled trials (RCTs) conducted between 2004 and 2024, involving a total of 2,376 patients. This study, published in the Annals of Surgery, sheds light on the benefits of incorporating mental health interventions before surgery.
What is Psychological Prehabilitation?
Psychological prehabilitation refers to a proactive approach aimed at improving surgical outcomes through preventive measures, with a specific focus on mental health. Traditionally, prehabilitation has centered on enhancing physical function and providing patient education. However, recent research has recognized the significant role mental health plays in postoperative recovery, including reducing persistent opioid use and improving overall patient outcomes.
Study Methods
The researchers conducted a systematic review, meta-analysis, and meta-regression of RCTs retrieved from reputable databases such as MEDLINE, EMBASE, CENTRAL, and Google Scholar. The included studies featured more than 50 adult surgical patients and evaluated various preoperative psychotherapy-based interventions. These interventions included cognitive behavioral therapy (CBT), supportive psychotherapy, and acceptance and commitment therapy (ACT). The aim was to assess the effects of these therapies on postoperative outcomes such as pain, anxiety, depression, and hospital stay duration.
Key Findings
The study revealed several important findings about the effects of psychological prehabilitation:
Reduced Length of Hospital Stay: Psychological prehabilitation resulted in an average reduction of 1.62 days in hospital stays.
Pain Reduction: Patients who underwent psychological prehabilitation experienced a decrease in pain by an average of 3.52 points on a pain scale.
Lower Anxiety and Depression Levels: The research showed significant reductions in anxiety and depression levels in patients who received psychological prehabilitation, regardless of the specific anxiety and depression scales used to measure these outcomes.
Psychotherapy Type and Surgical Type: Interestingly, the study found that the type of psychotherapy (CBT, supportive psychotherapy, or ACT) and the type of surgery did not significantly affect the outcomes. The only exception was in anxiety reduction, where certain interventions appeared more effective for managing anxiety.
Implications for Healthcare
These findings suggest that incorporating psychological prehabilitation into pre-surgery routines could lead to better overall recovery for patients. This approach not only helps improve mental well-being but also offers practical benefits, such as reducing the length of hospital stays and minimizing pain, anxiety, and depression following surgery. By improving recovery times and reducing the incidence of postoperative complications, psychological prehabilitation could help lower healthcare costs.
Future Research
While the study highlights the potential of psychological prehabilitation, it also calls for further research to refine the approach. The study points to the need for future investigations that compare the effectiveness of different types, durations, and delivery methods of psychotherapy. By doing so, researchers hope to determine the most effective strategies for achieving specific postoperative outcomes and enhance the overall effectiveness of prehabilitation programs.
Conclusion
Psychological prehabilitation is emerging as an important component in improving surgical recovery. With its proven benefits in reducing hospital stays, pain, anxiety, and depression, this approach could become a standard part of surgical preparation. As the research community continues to explore the most effective ways to deliver these mental health interventions, the hope is that psychological prehabilitation will become an integral part of pre-surgical care, leading to better outcomes for patients and reduced healthcare costs.
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