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Recent research spearheaded by surgeons at UCLA Health has revealed that psychological prehabilitation can play a significant role in optimizing recovery following surgical procedures. Led by Anne E. Hall in the lab of Dr. Justine Lee, the study analyzed data from 20 randomized controlled trials (RCTs) conducted between 2004 and 2024, involving a cohort of 2,376 patients. The findings were published in the Annals of Surgery.
Understanding Psychological Prehabilitation
Psychological prehabilitation refers to a proactive strategy aimed at enhancing surgical results through preventive interventions. While traditional prehabilitation has predominantly focused on physical conditioning and educating patients, recent emphasis on mental well-being highlights its essential influence on recovery post-surgery, including the mitigation of lasting opioid dependency.
The research included a systematic review, meta-analysis, and meta-regression of RCTs sourced from MEDLINE, EMBASE, CENTRAL, and Google Scholar. This involved studies with over 50 adult surgical patients, examining various psychotherapy-based preoperative interventions such as cognitive behavioral therapy (CBT), supportive psychotherapy, and acceptance and commitment therapy (ACT) to evaluate their impacts on postoperative recovery.
Results indicated that psychological prehabilitation leads to substantial improvements in recovery metrics. Key findings included:
- A reduction in average length of hospital stay (LOS) by 1.62 days;
- A decrease in pain levels by an average of 3.52 points;
- Lower anxiety scores across all validated anxiety assessment tools;
- Reduced depression levels irrespective of the specific depression scale utilized.
Interestingly, the type of psychotherapy employed and the surgical procedure performed had little impact on the overall outcomes, with anxiety being an exception.
Implications for the Healthcare Sector
The outcomes of this study underscore the potential benefits of integrating psychological prehabilitation into standard preoperative care protocols. Not only could this approach enhance patient recovery, but it may also contribute to lowering healthcare expenses by minimizing extended hospital stays and postoperative complications.
Moreover, the research underlines the necessity for additional studies to identify the most effective types, lengths, and methods of delivering psychotherapy, which could optimize recovery for various surgical procedures.
Source
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