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Psychological risk factors for chronic post-surgical pain after inguinal hernia repair surgery: A prospective cohort study

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Errata

This article is corrected by:

  1. Errata: Corrigendum Volume 17, Issue 3, 463, Article first published online: 6 February 2013

  • Funding sources

    None

  • Conflicts of interests

    None declared

Correspondence

R. Powell

Psychology, School of Life and Health Sciences, Aston University, Aston Triangle, Birmingham B4 7ET, UK. Tel.: +44 (0)121 204 4188.

E-mail: r.k.powell@aston.ac.uk

URL: http://www1.aston.ac.uk/lhs/staff/az-index/rachael-powell/

Abstract

A significant proportion of patients experience chronic post-surgical pain (CPSP) following inguinal hernia surgery. Psychological models are useful in predicting acute pain after surgery, and in predicting the transition from acute to chronic pain in non-surgical contexts. This is a prospective cohort study to investigate psychological (cognitive and emotional) risk factors for CPSP after inguinal hernia surgery. Participants were asked to complete questionnaires before surgery and 1 week and 4 months after surgery. Data collected before surgery and 1 week after surgery were used to predict pain at 4 months. Psychological risk factors assessed included anxiety, depression, fear-avoidance, activity avoidance, catastrophizing, worry about the operation, activity expectations, perceived pain control and optimism. The study included 135 participants; follow-up questionnaires were returned by 119 (88.1%) and 115 (85.2%) participants at 1 week and 4 months after surgery respectively. The incidence of CPSP (pain at 4 months) was 39.5%. After controlling for age, body mass index and surgical variables (e.g. anaesthetic, type of surgery and mesh type used), lower pre-operative optimism was an independent risk factor for CPSP at 4 months; lower pre-operative optimism and lower perceived control over pain at 1 week after surgery predicted higher pain intensity at 4 months. No emotional variables were independently predictive of CPSP. Further research should target these cognitive variables in pre-operative psychological preparation for surgery.

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