The Role of Negative Affect and Experiential Avoidance in Postsurgical Pain and Fatigue Among Norwegian Women With Breast Cancer

IF 3.5 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-01-21 DOI:10.1002/ejp.4788

Maria Frøseth Rosenblom, Silje Endresen Reme, Henrik Børsting Jacobsen

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引用次数: 0

Abstract

Background

Women undergoing breast cancer surgery frequently experience postsurgical pain and fatigue, which reduces their quality of life. Although psychological factors have been shown to play a role in predicting postsurgical outcomes, the subacute recovery phase often remains underexplored. In this secondary analysis of data from a randomised controlled trial, we sought to investigate the predictive role of negative affect and experiential avoidance on postsurgical symptoms during both acute and subacute recovery.

Methods

From the initial sample, 189 women who met the inclusion criteria completed the Acceptance and Action Questionnaire (AAQ-II) before surgery to assess levels of negative affect and experiential avoidance. Postsurgical pain and fatigue were measured at hospital discharge and again 3–4 weeks later using a 100 mm Visual Analogue Scale (VAS).

Results

Bivariate linear regression analyses revealed that higher presurgical negative affect and experiential avoidance significantly predicted increased levels of all acute and subacute postsurgical symptoms (all p ≤ 0.027). After adjusting for covariates in multivariate regression analyses, the AAQ-II remained a predictor of acute pain unpleasantness (p = 0.011) and fatigue (p = 0.048), although the effect estimates were modest.

Conclusions

These findings underscore the need to take psychological factors into account in treatment planning for acute postsurgical symptoms in order to develop more individualised approaches to optimise recovery for women undergoing breast cancer surgery.

Significance

Women with higher levels of negative affect and experiential avoidance before undergoing breast cancer surgery appear to be at greater risk for experiencing heightened acute postsurgical pain and fatigue. The identification of these psychological predictors can help clinicians recognise individuals at risk for severe postoperative symptoms and develop targeted preventive and curative interventions to mitigate these symptoms and prevent them from becoming chronic.

查看原文本刊更多论文

负面情绪和经验回避在挪威乳腺癌妇女术后疼痛和疲劳中的作用。

背景：接受乳腺癌手术的女性经常经历术后疼痛和疲劳，这降低了她们的生活质量。虽然心理因素已被证明在预测术后预后方面发挥作用，但亚急性恢复阶段往往仍未得到充分探讨。在对一项随机对照试验数据的二次分析中，我们试图研究急性和亚急性恢复期间负面情绪和经验回避对术后症状的预测作用。方法：从最初的样本中，189名符合纳入标准的妇女在手术前完成接受和行动问卷（AAQ-II），以评估负面影响和经验回避的水平。术后疼痛和疲劳在出院时和3-4周后再次使用100 mm视觉模拟量表（VAS）进行测量。结果：双变量线性回归分析显示，较高的术前负面情绪和经验回避显著预测所有急性和亚急性术后症状水平的增加（均p≤0.027）。在多变量回归分析中调整协变量后，AAQ-II仍然是急性疼痛不愉快（p = 0.011）和疲劳（p = 0.048）的预测因子，尽管效果估计是适度的。结论：这些发现强调了在制定急性术后症状的治疗计划时考虑心理因素的必要性，以便开发更个性化的方法来优化乳腺癌手术妇女的恢复。意义：在接受乳腺癌手术前，负面情绪和经验回避水平较高的女性出现急性术后疼痛和疲劳加剧的风险更大。识别这些心理预测因素可以帮助临床医生识别有严重术后症状风险的个体，并制定有针对性的预防和治疗干预措施，以减轻这些症状并防止其成为慢性症状。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.