A new analysis led by surgeons from UCLA Health finds that psychological prehabitation can significantly improve recovery after surgery. The investigation, directed by Anne E. Hall in the laboratory of Dr. Justine Lee, analyzed data of 20 random controlled trials (BC) carried out between 2004 and 2024, which implies a total of 2,376 patients. It is published in the Annals of Surgery
What is psychological prehabilitation?
Prehabitation is a proactive approach aimed at improving surgical results through preventive measures. Traditionally, it has focused on the physical function and patient’s education. However, mental health has recently caught attention due to its crucial role in postoperative recovery, including the reduction of persistent opioid use.
The researchers conducted a systematic review, meta-analysis and meta-recreation of ECA recovered from databases such as Medline, Embase, Central and Google Scholar. They included studies with more than 50 adult surgical patients and evaluated the effects of different interventions based on preoperative psychotherapy, including cognitive behavioral therapy (CTC), supporting psychotherapy and acceptance and commitment therapy (ACT), in postoperative results.
The study found that psychological prehabitation significantly reduces the duration of hospital stay, pain, anxiety and depression after surgery. Specifically, the analysis showed:
- A reduction in the duration of hospital stay (the) in an average of 1.62 days;
- A decrease in pain in an average of 3.52 points;
- Lower anxiety levels, regardless of which validated anxiety scale it was used;
- Reduced depression levels, regardless of which validated depression scale it was used.
Interestingly, the type of psychotherapy and the type of surgery did not significantly affect the results, except for anxiety.
Implications for medical care
The findings suggest that the incorporation of psychological prehability in surgery prior to surgery could lead to a better general recovery for patients. This approach can also help reduce medical care costs associated with stays in prolonged hospitals and postoperative complications.
The study highlights the need for greater research to compare different types, durations and psychotherapy delivery methods to determine the most effective strategies for specific postoperative results.