Psychological influences on surgical recovery: Perspectives from psychoneuroimmunology.

TLDR

Preoperative fear and anxiety are linked to slower, more complicated postoperative recovery, likely through behavioral and physiological pathways, with psychoneuroimmunology showing that stress delays wound healing and pain adversely affects endocrine and immune function. The study proposes a biobehavioral model outlining how psychological and behavioral responses influence surgical and postoperative outcomes. The model maps behavioral and physiological mechanisms by which preoperative anxiety and pain affect wound healing and immune function. The model’s clinical and research implications are discussed.

Abstract

Greater fear or distress prior to surgery is associated with a slower and more complicated postoperative recovery. Although anxiety presumably interferes with recuperation through both behavioral and physiological mechanisms, the pathways have been unclear. Recent work in psychoneuroimmunology (PNI) has demonstrated that stress delays wound healing. In addition, a second line of research has illustrated the adverse effects of pain on endocrine and immune function. A biobehavioral model is described that is based on these and other data; it suggests a number of routes through which psychological and behavioral responses can influence surgery and post-surgical outcomes. Clinical and research implications are highlighted.