THE RELATIONSHIP BETWEEN PREOPERATIVE PAIN BELIEFS AND SURGICAL FEAR WITH POSTOPERATIVE PAIN IN SURGICAL PATIENTS

Öz

Objective: The study aimed to examine the relationship between preoperative surgical fear and pain beliefs and pain scores recorded in the first 24 hours after surgery. Method: A descriptive and correlational research design was employed in the study. The study included 292 surgical patients who underwent surgery in the general surgery clinic of a training and research hospital. The data were collected through face-to-face interviews using the Patient Identification Form, Visual Analog Scale-Pain, Pain Beliefs Questionnaire, and Surgical Fear Questionnaire. The data were analyzed using the SPSS program. Results: In the first 24 hours after surgery, the patients' mean pain and surgical fear level scores were found to be low, and the mean pain beliefs subscale scores were found to be moderate. A significant correlation was found between patients' pain level and surgical fear mean scores (r=.28, p<.001), while no significant correlation was found with pain belief mean scores (r=.04, p=0.44). Patients' pain levels were also found to differ significantly according to gender (p<.01), chronic disease (p<.05), surgical interventions (p<.001), and type of surgery (p<.05). Conclusion: In this study, a significant relationship was identified between preoperative surgical fear and postoperative pain intensity. Accordingly, systematic assessment of fear levels during the preoperative period is essential, particularly for providing early information, psychological support, and the development of appropriate coping strategies for high-risk patients. It is considered that such multidisciplinary approaches will facilitate patients' adaptation to the surgical process and optimize clinical outcomes.

Anahtar Kelimeler

• Preoperative Care
• Fear
• Postoperative Care
• Pain
• Nursing Care

CERRAHİ HASTALARDA AMELİYAT ÖNCESİ AĞRI İNANÇLARI VE CERRAHİ KORKU İLE AMELİYAT SONRASI AĞRI ARASINDAKİ İLİŞKİ

Öz

Amaç: Çalışma, ameliyat öncesi cerrahi korku ve ağrı inanç düzeyleriyle ameliyat sonrası ilk 24 saatte kaydedilen ağrı düzeyleri arasındaki ilişkiyi incelemek amacıyla yapıldı. Yöntem: Çalışmada tanımlayıcı ve ilişki arayıcı bir araştırma tasarımı kullanıldı. Çalışmaya, bir eğitim ve araştırma hastanesinin genel cerrahi kliniğinde ameliyat olan 292 hasta dahil edildi. Veriler, Hasta Tanımlama Formu, Görsel Analog Skala-Ağrı, Ağrı İnançları Ölçeği ve Cerrahi Korku Ölçeği kullanılarak, yüz yüze görüşme yoluyla toplandı. Veriler SPSS programı kullanılarak analiz edildi. Bulgular: Ameliyat sonrası ilk 24 saatte hastaların ortalama ağrı ve cerrahi korku düzeyi puan ortalamalarının düşük, ağrı inançları alt ölçek puan ortalamalarının ise orta düzeyde olduğu bulundu. Hastaların ağrı düzeyi puan ortalamaları ile cerrahi korku puan ortalamaları arasında anlamlı bir ilişki olduğu (r=.28, p<.001), ağrı inancı puan ortalaması arasındaki ilişkinin anlamlı olmadığı belirlendi (r=.04, p=.44). Hastaların ağrı düzeylerinin; cinsiyet (p<.01), kronik hastalık (p<.05), önceki cerrahi müdahaleler (p<.001) ve ameliyat türü (p<.05) değişkenlerine göre de anlamlı farklılık gösterdiği belirlendi. Sonuç: Bu çalışmada, cerrahi korku düzeyi ile postoperatif ağrı şiddeti arasında anlamlı bir ilişki olduğu saptandı. Bu doğrultuda, preoperatif dönemde hastaların korku düzeylerinin sistematik olarak değerlendirilmesi ve özellikle yüksek risk grubundaki hastalara yönelik erken dönem bilgilendirme, psikolojik destek ve uygun baş etme stratejilerinin geliştirilmesi önemlidir. Bu tür yaklaşımların, hastaların cerrahi sürece uyumunu kolaylaştıracağı ve klinik çıktıları optimize edeceği düşünülmektedir.

Anahtar Kelimeler

• Preoperatif Bakım
• Korku
• Postoperatif Bakım
• Ağrı
• Hemşirelik Bakımı

Kaynakça

1. Zhang YE, Xu X, Gong R. Postoperative pain management outcomes at a Chinese hospital: A cross-sectional survey. J Perianesth Nurs. 2023;38(3):434-439.
2. Chou R, Gordon DB, de Leon-Casasola OA, et al. Management of postoperative pain: a clinical practice guideline from the American pain society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' committee on regional anesthesia, executive committee, and administrative council. Pain. 2016;17(2):131-157.
3. Yang G, Zang X, Ma X, Bai P. Translation, cross-cultural adaptation, and psychometric properties of the chinese version of the surgical fear questionnaire. J Perianesth Nurs. 2022;37(3):386-392.
4. Yazici G, Yilmaz K, Bulut H, et al. The prevalence of pain in the first 24 hours after surgery: A multicenter study. J Perianesth Nurs. 2022;37(1):122-129.
5. Zengin Aydin L, Dogan A. The effect of guided imagery on postoperative pain management in patients undergoing lower extremity surgical operations: a randomized controlled trial. Orthop Nurs. 2023;42(2):105-112.
6. Wiech K, Ploner M, Tracey I. Neurocognitive aspects of pain perception. Trends Cogn Sci. 2008;12(8):306-313.
7. Jensen MP, Galer PD, Johnson LL, George HR, Mendoza ME, Gertz KJ. The associations between pain-related beliefs, pain intensity, and patient functioning: hypnotizability as a moderator. Clin J Pain. 2016;32(6):506-512.
8. Matthies N, Keshen S, Lewis S, Webster F, Perruccio AV, Rampersaud YR. An exploratory analysis of spine patients' preoperative concerns and decision-making process: does what surgeons say matter? Spine (Phila Pa 1976). 2020;45(15):1067-1072.

9. Eberhart L, Aust H, Schuster M, et al. Preoperative anxiety in adults-a cross-sectional study on specific fears and risk factors. BMC Psychiatry. 2020;20(1):140.
10. Celik F, Edipoglu IS. Evaluation of preoperative anxiety and fear of anesthesia using APAIS score. Eur J Med Res. 2018;23(1):41.
11. Ursavas FE, Yaradilmis YU. Relationship between pain beliefs and postoperative pain outcomes after total knee and hip replacement surgery. J Perianesth Nurs. 2021;36(2):187-193.
12. Disceken FM, Kose G. Association of preoperative pain beliefs with postoperative pain levels in abdominal surgery patients. J Clin Nurs. 2021;30(21-22):3249-3258.
13. Ferreira-Valente A, Sharma S, Torres S, et al. Does religiosity/spirituality play a role in function, pain-related beliefs, and coping in patients with chronic pain? a systematic review. J Relig Health. 2022;61(3):2331-2385.
14. Yildizeli Topcu S. Relations among pain, pain beliefs, and psychological well-being in patients with chronic pain. Pain Manag Nurs. 2018;19(6):637-644.
15. Riecke J, Zerth SF, Schubert AK, Wiesmann T, et al. Risk factors and protective factors of acute postoperative pain: an observational study at a German university hospital with cross-sectional and longitudinal inpatient data. BMJ Open. 2023;13(5):e069977.
16. Ozmen N, Bayraktar E. Does preoperative pain belief affect postoperative pain and breastfeeding? J Perianesth Nurs. 2023;38(5):e8-e14.
17. Price DD, McGrath PA, Rafii A, Buckingham B The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983;17(1):45-56.
18. Aydin A, Araz A, Aslan A. Visual analog scale and emotion lattice: Adaptation to our culture. Turkish Psychology Writings. 2011;14(27):1-13.
19. Edwards LC, Pearce SA, Turner-Stokes L, Jones A. The Pain Beliefs Questionnaire: an investigation of beliefs in the causes and consequences of pain. Pain. 1992;51(3):267-272.
20. Berk HO. The experience of chronic pain and pain beliefs: The Turkish validation study of the pain beliefs questionnaire. 10th European Congress of Psychology, Praha, Czech Republic, 2007.
21. Theunissen M, Peters ML, Schouten EG, et al. Validation of the surgical fear questionnaire in adult patients waiting for elective surgery. PloS one. 2014;9(6);e100225.
22. Bagdigen M, Karaman Ozlu Z. Validation of the Turkish version of the surgical fear questionnaire. J Perianesth Nurs. 2018;33(5):708-714.
23. Helden EV, Kranendonk J, Vermulst A, et al. Early postoperative pain and 30-day complications following major abdominal surgery: a retrospective cohort study. Reg Anesth Pain Med. 2025;50(8):651-657.
24. Casale R, Atzeni F, Bazzichi L, et al. Pain in Women: A perspective review on a relevant clinical issue that deserves prioritization. Pain Ther. 2021;10(1):287-314.
25. Athnaiel O, Cantillo S, Paredes S, Knezevic NN. The role of sex hormones in pain-related conditions. Int J Mol Sci. 2023;24(3)1866.
26. Clauw DJ, Essex MN, Pitman V, Jones KD. Reframing chronic pain as a disease, not a symptom: rationale and implications for pain management. Postgrad Med. 2019;131(3):185-198.
27. Yang S, Chang MC. Chronic pain: Structural and functional changes in brain structures and associated negative affective states. Int J Mol Sci. 2019;20(13).
28. Ali I, Akbar F, Khan AA, Ali Z, Ahmad W, Kamal SA. Outcome of open repair versus laparoscopic surgery in patients with duodenal ulcer perforation. Journal of Medical & Health Sciences Review. 2025;2(2):5339-5345.
29. Sarin D, Memon HNA, Sughra G, et al. The Role of Laparoscopy in Modern Gynecology: Advancements, Applications, and Clinical Outcomes. Indus J Biosci Res. 2025;3(5):131-142.
30. Akutay S, Ceyhan O. The relationship between fear of surgery and affecting factors in surgical patients. Perioper Med (Lond). 2023;12(1):22.
31. Odabasi G, Kucukakca Celik G, Asci O. Evaluation of surgical fear level and postoperative consequences in patients undergoing laparoscopic sleeve gastrectomy. Bariatr Surg Pract Patient Care. 2023;18(1):40-48.
32. Deniz Dogan S, Yurtseven S, Arslan S. The effect of preoperative pain, fear, and anxiety on postoperative pain in urological surgery patients: A descriptive and correlational study. J Perianesth Nurs. 2024;39(2):202-206.
33. Caumo W, Schmidt AP, Schneider CN, et al. Risk factors for preoperative anxiety in adults. Acta Anaesthesiol Scand. 2001;45(3):298-307.
34. Surme Y. Stress, Stress related diseases and stress management. J Int Soc Res. 2019;12(64):525-529.
35. Kose G, Sirin K. Effects of pain beliefs on postoperative pain and analgesic consumption in spine surgery patients. J Neurosci Nurs. 2023;55(6):228-234.
36. Walton LL, Duff E, Arora RC, McMillan DE. Surgery patients' perspectives of their role in postoperative pain: A scoping review. Int J Nurs Stud Adv. 2023;5:100124.
37. Elphinston RA, Sullivan MJL, Sterling M, et al. Pain Medication Beliefs Mediate the Relationship Between Pain Catastrophizing and Opioid Prescription Use in Patients With Chronic Non-Cancer Pain. J Pain. 2022;23(3):379-389.
38. Thompson EL, Broadbent J, Bertino MD, Staiger PK. Do Pain-related Beliefs Influence Adherence to Multidisciplinary Rehabilitation? A Systematic Review. Clin J Pain. 2016;32(2):164-178.