Getting your mind ready for surgery is as important as physical preparation

Preparing for major surgery should not skip mental preparation for a successful recovery, a new study says. Failing to address patients’ mental health before serious surgery could hinder their recovery, particularly among older patients, according to a new study published on Wednesday in JAMA Network Open. “The stress of surgery can worsen anxiety and depression symptoms and affect patients’ recovery and overall health,” the study’s first author Joanna Abraham said in a press release. The authors argue that pre-surgical care should include not only physical preparation but also mental preparation from trained mental health professionals – something that current perioperative care usually misses. “We recognize the importance of getting the body into shape before surgery, but preparing the mind and the brain is just as important,” said the study’s senior author Eric J. Lenze. The way forward is to treat patients “holistically,” said Michael S. Avidan, uniting anesthesiology and psychiatry. The power of a call The study included 306 adults aged 60 and older who were scheduled for cardiac, oncologic or orthopaedic surgery. Patients were divided into two groups. One group got only self-help materials to read independently, while the other group talked with a trained mental health professional such as a social worker or mental health counsellor over eight to 12 phone sessions. The second group also received a personalised review by pharmacists and doctors to safely optimise doses of high-risk medications. Three months after surgery, patients who received consultation from mental health professionals and medication reviews experienced a 2.2-to-2.5-point greater reduction in symptoms of depression and anxiety than those given educational materials alone, based on a 48-point scale. Older adults undergoing cancer surgery experienced the strongest mental health improvements, scoring nearly five points lower than the control group. Patients also reported positive experiences with the extra care, both from the wellness providers and the pharmacists who worked to eliminate unnecessary medications. “What makes this care model so promising is that it’s practical to deliver,” said Abraham. “Patients and healthcare providers found the program manageable and easy to integrate into existing surgical workflows. Proactive mental health care doesn’t have to burden the hospital system.”