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Prognostic model for psychological outcomes in ambulatory surgery patients: A prospective study using a structural
Hendrik-Jan Mijderwijk1, Robert Jan Stolker1, Hugo J Duivenvoorden1
1Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Preoperative anxiety, fatigue, depression, and self-efficacy significantly predict psychological outcomes after day-case surgery. This model helps identify patients needing extra support to improve surgical recovery.
Area of Science:
- Psychology
- Surgery
- Health Services Research
Background:
- Day-case surgery is increasing globally.
- Psychological outcomes are becoming more prominent in surgical care.
- Predicting these outcomes is crucial for patient management.
Purpose of the Study:
- To prospectively evaluate prognostic variables for psychological outcomes after day-case surgery.
- To identify sociodemographic, medical, and psychological predictors.
- To develop a predictive model for postoperative psychological status.
Main Methods:
- Prospective study of 398 patients undergoing day-case surgery.
- Structural equation modeling used to analyze presurgical variables.
- Variables included sociodemographics, medical status, anxiety (STAI, HADS-A), fatigue (MFI), aggression (STAS), depressive moods (HADS-D), self-esteem, and self-efficacy.
- Psychological outcomes assessed on day 7 post-surgery.
Main Results:
- A prognostic model identified anxiety (STAI, HADS-A), fatigue (MFI), depression (HADS-D), aggression (STAS), self-efficacy, sex, and having children as significant predictors.
- Baseline psychological variables were prominent predictors.
- STAI-Trait score was the strongest overall predictor.
- Models predicted STAI-State (R2=0.44), STAI-Trait (0.66), HADS-A (0.45), and STAS-Trait (0.54).
Conclusions:
- A validated prognostic model accurately predicts postoperative psychological outcomes in day-case surgery.
- This model enables early identification of vulnerable patients.
- Identified patients may benefit from additional preventive treatment or careful consideration for day-case surgery selection.
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