Podium Presentation 6th World Congress on Positive Psychology 2019

Psychological Health: Possibly the Most Important Surgical Risk Factor (#51)

Rhonda Cornum 1 , John Tokish 2 , James Shaha 3
  1. Techwerks, North Midletown, KENTUCKY, United States
  2. Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
  3. Department of Orthopedics, Landstuhl Regional Medical Center, Landstuhl, Germany

The relationship between psychological and physiologic health is nowhere more important than surgery. Since psychological health is rarely measured, potential risks are not discussed.

Predeployment psychological health and post deployment symptoms following injury was done on Soldiers deployed from 2009-2010. The "GAT" quantifies psychological fitness, and the Post Deployment Health Assessment documents health information. Outcomes from both shoulder arthroplasty and instability surgery were measured on 75 and 25 consecutive patients respectively. The Brief Resilience Scale was administered preoperatively. Patients were divided into low (< 4.0) or high (> 4.0) resilience.

Rate of injury and immediate symptoms were the same across the spectrum of psychological health.  Soldiers in the lowest decile of resilience complain of persistent symptoms at a significantly higher rate than Soldiers in the upper five resilience deciles (37% vs 25%). In the surgical studies, the Western Ontario Instability Index, American Shoulder and Elbow Score, recovery time and rate of military discharge were all significantly related to the preoperative resilience score.  

Significant relationships between baseline resilience and outcome from both injury and selected orthopedic procedures were demonstrated. Psychological health can be improved with education. Psychologists should partner with surgeons, driving preoperative improvement in psychological health to improve surgical outcomes.