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Recovery expectancies impact postdischarge recovery 42 days after laparoscopic sacrocolpopexy

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Abstract

Introduction and hypothesis

The aim of this retrospective cohort study was to determine if recovery expectancies were associated with actual postdischarge recovery after laparoscopic sacrocolpopexy.

Methods

Study subjects (N = 167) undergoing laparoscopic sacrocolpopexy were asked to preoperatively predict the likelihood of a prolonged postdischarge recovery (> 42 days). Low, medium, and high recovery expectancy groups were created from responses to the likelihood of prolonged postdischarge recovery question. Previously established predictors of actual recovery 42 days after laparoscopic sacrocolpopexy included age, body mass index, Charlson co-morbidity index, short form (SF)-36 bodily pain scores, doctors’ and others’ health locus of control, and sick role investment. One parsimonious hierarchical linear and logistic regression model was constructed to determine if preoperative recovery expectancies were independently associated with PSR13 scores and “significant” postdischarge recovery after controlling for previously established predictors.

Results

Study subjects with high recovery expectancies had higher PSR13 scores than subjects with low recovery expectancies (82.32 ± 15.34 vs 73.30 ± 15.30, mean difference 9.01, 95%CI 1.08–16.94). Study subjects with low recovery expectancies scored 7.7 points lower on the PSR13 scale (minimally important difference = 5), which translated into a 73% reduction in the likelihood of being “significantly” recovered 42 days after surgery, after controlling for previously established predictors.

Conclusions

A low recovery expectancy has a negative impact on actual recovery 42 days after laparoscopic sacrocolpopexy. Our findings are important because preoperative recovery expectancies are modifiable predictors, making them a candidate for an expectancy manipulation intervention designed to optimize recovery after pelvic reconstructive surgery.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, School of Medicine, Indiana University, 11725 North Illinois Street, K140, Indianapolis, IN, 46032, USA

    Michael Heit & Christine Pan

  2. Department of Community and Health Systems, School of Nursing, Indiana University, Indianapolis, IN, USA

    Chen X. Chen

  3. Department of Psychology, School of Science, Indiana University-Purdue University, Indianapolis, IN, USA

    Kevin L. Rand

Authors
  1. Michael Heit
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  2. Chen X. Chen
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  3. Christine Pan
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  4. Kevin L. Rand
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Correspondence to Michael Heit.

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Financial support

Dr. Chen is supported by the Grant Numbers KL2 TR002530 and UL1 TR002529 (A. Shekhar, PI) from the National Institutes of Health, National Center for Advancing Translational Sciences. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, which had no direct role in this or the original study.

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Heit, M., Chen, C.X., Pan, C. et al. Recovery expectancies impact postdischarge recovery 42 days after laparoscopic sacrocolpopexy. Int Urogynecol J 32, 1527–1532 (2021). https://doi.org/10.1007/s00192-020-04586-w

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  • DOI: https://doi.org/10.1007/s00192-020-04586-w

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