Effectiveness Evaluation and Predictive Model Construction of Multi-modal Intervention Program Based on Psychological Resilience Theory in Perioperative Anxiety Management for Cataract Surgery

To investigate the effectiveness of a multi-modal intervention program based on psychological resilience theory in perioperative anxiety management for cataract surgery and to establish an anxiety risk prediction model.

A prospective randomized controlled trial was conducted, including 120 patients who underwent phacoemulsification with intraocular lens implantation in the ophthalmology department of the hospital from March 2024 to March 2025. Participants were randomly assigned to an intervention group (n=63) and a control group (n=57). The control group received routine perioperative care, while the intervention group received a psychological resilience theory-based intervention program in addition to routine care. The primary outcome measure was the change in State-Trait Anxiety Inventory (STAI) state anxiety scores. Secondary outcome measures included Connor-Davidson Resilience Scale (CD-RISC-25) scores, Generalized Anxiety Disorder Scale (GAD-7) scores, Pittsburgh Sleep Quality Index (PSQI), physiological indicators (blood pressure, heart rate), Visual Analog Scale (VAS) pain scores, surgical cooperation scores, and postoperative complication rates. Multiple stepwise regression analysis was used to construct an anxiety risk prediction model, and receiver operating characteristic (ROC) curve analysis was employed to evaluate the model's predictive performance.

No statistically significant differences were found in baseline characteristics between the 2 groups (all P > .05). The intervention group demonstrated significantly greater reductions in STAI state anxiety scores compared to the control group at all follow-up time points. At 1 month postoperatively, the intervention group achieved a mean reduction of 16.6 ± 8.9 points compared to 9.6 ± 7.2 points in the control group (mean difference=7.0, 95% CI: 3.9-10.1, P < .001). The intervention group showed significantly greater improvements in CD-RISC-25 scores at 1-month follow-up compared to the control group (mean increase: 16.1 ± 9.8 vs. 3.6 ± 8.2 points, P < .001). The GAD-7 and PSQI scores showed significantly greater reductions in the intervention group at all postoperative time points (all P < .001). At 30 minutes preoperatively, the intervention group showed significantly lower systolic blood pressure, diastolic blood pressure, and heart rate compared to the control group (127.8 ± 13.2 vs. 137.4 ± 16.1 mmHg, 77.9 ± 9.4 vs. 84.2 ± 11.3 mmHg, 74.2 ± 10.8 vs. 86.7 ± 13.4 beats/min, respectively, all P ≤ .001). The intervention group demonstrated significantly lower VAS pain scores at all postoperative time points, higher surgical cooperation scores (4.3 ± 0.8 vs. 3.6 ± 0.9, P < .001), shorter time to first ambulation (7.2 ± 2.4 vs. 9.8 ± 3.1 hours, P < .001), and reduced length of stay (2.3 ± 0.7 vs. 2.9 ± 0.9 days, P < .001). The total incidence of postoperative complications was significantly lower in the intervention group compared to the control group (28.6% vs. 56.1%, P=.003). The constructed anxiety risk prediction model included 7 predictive factors: age, gender, education level, previous surgical history, baseline blood pressure, baseline psychological resilience level, and social support score. The model demonstrated good fit (R ²=0.689, adjusted R ²=0.671), with an area under the ROC curve of 0.863 (95% CI: 0.802-0.924), sensitivity of 84.2%, and specificity of 81.4%.

The multi-modal intervention program based on psychological resilience theory effectively reduces perioperative anxiety levels in cataract patients, enhances psychological resilience, improves physiological indicators, alleviates postoperative pain, increases surgical cooperation, shortens recovery time, and reduces complication rates. The constructed anxiety risk prediction model demonstrates good predictive performance.