Fatigue after colorectal surgery and its relationship to patient expectations

Feelings of fatigue are pronounced even after uncomplicated abdominal surgery. Patient expectations are associated with a variety of postsurgical outcomes, but few data about fatigue prevalence, nature, and time frame are available for patients and health professionals. Therefore, this study sought to investigate the effect of patient expectations on fatigue experiences following major colorectal surgery.

Based on the common sense model of illness self-regulation, prior to surgery 51 patients were asked to complete questionnaires assessing their perceptions of likely time frame and ability to control their return to normal functioning after surgery, using subset of questions from the Revised Illness Perceptions Questionnaire. Experience of fatigue and impact of fatigue were also assessed for 2 mo postsurgery using the Identity-Consequences Fatigue Scale.

Using mixed model linear regression, baseline depression scores exerted significant main effects on both Fatigue Experiences and Fatigue Impacts scores of the patients. Further, after controlling for depression, there remained significant expectation interactions with both Fatigue Experiences and Fatigue Impacts scores.

Postsurgical fatigue is multidimensional and this should be considered in studies investigating this phenomenon. Patients who before surgery reported shorter expected fatigue resolution time lines and a higher degree of expected control, experienced more persistent fatigue following surgery.