Patients with large support network of family and friends fare better after an operation

A new study published in the February issue of the Journal of the American College of Surgeons shows that patients with a large support network of family and friends report feeling less pain and anxiety prior to having a surgical procedure, which can have a substantially positive impact on their postoperative recovery.

The findings suggest that it is important for clinicians to be aware of the close relationship between patients' social networks and their impact on preoperative pain and anxiety, and how these relationships can affect patient recovery after major operations.

“Strong social connectedness can have a tremendous impact on patient recovery by helping blunt the effect of stress caused by postoperative pain, as well as ease concerns about health, finances and separation from family members,” said Allison R. Mitchinson, MPH, NCTMB, research health science specialist, Department of Veterans Affairs, Ann Arbor (MI) Healthcare System.

Social network size and social connectedness have long been known to affect health and well-being. Stressful events such as having an operation can further increase the need for social support.

“Since patients with limited social connections will likely require more pain medications, have longer hospital stays, and need additional caregiver attention after a surgical procedure, it is important that physicians are aware of this link,” added study co-author Daniel B. Hinshaw, MD, FACS, a researcher with the Department of Veterans Affairs, Ann Arbor Healthcare System. “Patients should be preoperatively screened for pain and anxiety because these are strong predictors of a more difficult postoperative recovery.”

Patients undergoing major thoracic or abdominal operations at two Veterans Affairs' medical centers (n=605) participated in a randomized controlled trial of massage as adjuvant treatment for postoperative pain. Prior to the operations, patients were given a questionnaire assessing their number of friends and relatives and how frequently contact was made with the members of their social networks. Patients rated levels of pre- and postoperative pain intensity and unpleasantness, as well as postoperative levels of anxiety, depression, relaxation, and inner peace using visual analogue scales. Daily opiate use, postoperative complications, and length of stay were also evaluated. The study found that patients reporting a smaller social network had higher preoperative pain intensity, unpleasantness, and anxiety (p<0.001).