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Keywords:

  • Abdominal hysterectomy;
  • fast-track;
  • general anaesthesia;
  • spinal anaesthesia;
  • stress coping capacity

Please cite this paper as: Kjølhede P, Borendal Wodlin N, Nilsson L, Fredrikson M, Wijma K. Impact of stress coping capacity on recovery from abdominal hysterectomy in a fast-track programme: a prospective longitudinal study. BJOG 2012;119:998–1007.

Objective  To evaluate the effect of stress coping capacity in combination with mode of anaesthesia on postoperative recovery in fast-track abdominal hysterectomy.

Design  Prospective longitudinal study.

Setting  Five hospitals in the south-east of Sweden.

Population  A cohort of 162 women undergoing fast-track abdominal hysterectomy for benign conditions.

Methods  Self-administered questionnaires, the Stress Coping Inventory (SCI) and the Swedish Postoperative Symptom Questionnaire (SPSQ), and clinical information were collected prospectively. Stress coping capacity was categorised as high or low according to the summed score of the SCI. Comparisons of effect variables were adjusted using a propensity score-matching model.

Main outcome measures  Associations between stress coping capacity and hospital stay, sick leave, use of analgesic and self-reported postoperative symptoms.

Results  Women with high stress coping capacity had a significantly shorter sick leave, experienced postoperative symptoms significantly less often, and with lower intensity, than women with low stress coping capacity. With the exception of symptom intensity, these findings were related to having had the operation under spinal anaesthesia as opposed to general anaesthesia. Hospital stay, use of analgesics and abdominal pain were not related to stress coping capacity.

Conclusions  In patients for whom spinal anaesthesia was applied, high stress coping seems to be a quality that helps patients manage the burden of surgery. It is desirable for the individual, as well as for the healthcare system, to enhance recovery by using intervention programmes designed to improve or manage stress coping, particularly for individuals with low stress coping capacity. This recommendation merits further investigation.