Psychological distress in the preoperative period: an examination of healthcare-related correlates and a novel psychological intervention
Bibliographic record
Abstract
Psychological distress (i.e., a broad range of emotional reactions including worry, fear, helplessness) is commonly experienced by surgical patients in the preoperative period, and is associated with several adverse health-related outcomes including surgical complications, postoperative pain, and mortality, among others. Some research suggests preoperative distress may be particularly elevated among cancer surgery patients. In two studies, this thesis (1) examined adverse healthcare-related correlates associated with preoperative distress (Study 1), further highlighting the need for effective interventions, and (2) evaluated a novel preoperative intervention to mitigate preoperative distress (Study 2). Study 1 analyzed secondary data from the Vascular Events In Non-cardiac Surgery Patients Cohort Evaluation (VISION) study – Mental Health Supplement (N = 997; n = 370 with active cancer undergoing cancer surgery), which included the Kessler 6-item Psychological Distress Scale (administered preoperatively on the day of surgery). Regression analyses examined associations between preoperative distress and length of hospital stay and post-discharge institutionalization (e.g., transferred to another facility, new admission to a personal care home, re-hospitalization) among the full mixed surgical sample and among cancer surgery patients specifically. Among both groups, preoperative distress was associated with an increased length of hospital stay, and increased odds of re-hospitalization. In case-series format, Study 2 evaluated the feasibility of and preliminarily piloted a preoperative virtual reality (VR) intervention exposing breast cancer surgery patients to the operating room environment and preoperative process. Participants (N = 7) were assigned to the intervention group (n = 4) or control group (i.e., treatment as usual; n = 3) and completed validated symptom measures of distress and anxiety throughout the perioperative period. Those in the intervention group provided intervention feedback. Despite some recruitment challenges, the intervention was rated favourably and as helpful, with comments describing its realism, impacts on participants’ degree of preparedness/expectations, and relaxing/calming effect. Half of the intervention participants reported reduced distress/anxiety in between trialing the intervention and having surgery. Results underscore the importance of screening for and targeting psychological distress throughout the perioperative period. Findings also inform modifications to the VR intervention and study design of a large scale trial to evaluate the efficacy of the VR intervention.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".